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Rev. bras. ortop ; 57(1): 47-54, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1365749


Abstract Objective To study the parameters related to the insertion path of cortical screws and to describe this technique. Methods Computed tomography (CT) scans of 30 patients, as well as the measurements from the L1 to the L5 vertebrae, were studied. A second observer evaluated ten randomly-selected exams. The parameters studied included the lateral angle (LA) and the screw diameter (SD) as axial variables, and the cranial angle (CA) and screw length (SL) as sagittal variables. Results We studied 15 male patients (mean age: 31.33 years) and 15 female patients (mean age: 32.01 years). The LA varied between 13.8° and 20.89°, with a tendency to increase in the proximal to distal direction. The CA varied from 17.5° to 24.9°, with a tendency to decrease in the caudal direction. The SD ranged from 2.3 mm to 7.2 mm, with a tendency to increase as we progressed from proximal to distal. The SL varied from 19 mm to 45 mm, with a tendency to decrease as we proceeded from proximal (L1) to distal (L5). No statistical difference was observed between the genders or in the interobserver agreement regarding the values studied when comparing the sides. Conclusion The path of insertion of the cortical screw shows a variation in different populations. Therefore, we recommend a preoperative imaging study to reduce the surgical risks related to the technique.

Resumo Objetivo Estudar os parâmetros anatômicos do trajeto de inserção do parafuso cortical e descrever sua técnica. Métodos Analisaram-se exames de tomografia computadorizada de 30 pacientes, e as medidas nas vértebras de L1 a L5 bilateralmente. Um segundo observador avaliou dez exames aleatoriamente. Os parâmetros incluíram o ângulo lateral (AL) e o diâmetro do parafuso (DP) como variáveis axiais, e o ângulo cranial (AC) e o comprimento do parafuso (CP) como variáveis sagitais. Resultados No total, havia 15 pacientes do sexo masculino (média de idade de 31,33 anos) e 15 do sexo feminino (média de idade de 32,01 anos). O AL variou de 13,8° a 20,89°, com uma tendência de aumento no sentido de proximal a distal. O AC variou de 17,5° a 24,9°, com tendência de diminuição no sentido caudal. O DP variou de 2,3 mm a 7,2 mm, havendo uma tendência ao aumento conforme avançamos de proximal a distal. O CP variou de 19 mm a 45 mm, havendo uma tendência de diminuição conforme avançamos de proximal (L1) a distal (L5). Não houve diferença estatística entre os sexos, nem diferenças na confiabilidade interobservador, quanto aos valores estudados quando comparados os lados. Conclusão A trajetória do parafuso de trajeto cortical apresenta variações em diferentes populações. Assim, recomendamos o estudo pré-operatório de imagens para reduzir os riscos cirúrgicos relacionados à técnica.

Humans , Male , Female , Adult , Spine/anatomy & histology , Spine/surgery , Bone Screws , Tomography, X-Ray Computed , Minimally Invasive Surgical Procedures
Int. j. morphol ; 38(2): 415-422, abr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1056456


This study aimed to investigate the sagittal spinal-pelvic morphological changes, as well as the relationship between pelvic anatomical changes and the spinal-pelvic plane in patients with adolescent idiopathic scoliosis (AIS), in order to provide guidelines for orthopedic surgery in AIS. X-ray data were collected for retrospective analysis from 30 patients diagnosed as AIS in the Departments of Radiology at the Second Affiliated Hospital of Inner Mongolia Medical University and the Inner Mongolia International Mongolian Medical Hospital from April 2014 to November 2018, along with 30 normal adolescents as control. Pelvic parameters, including pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS), a spinal parameter, lumbar lordosis (LL), and anatomical parameters, including sacral width (SW) and femoral head- sacrum distance (FH-S), were measured. The spinal-pelvic parameters were compared between AIS patients and normal controls and also between male and female AIS patients. Pearson correlation was performed to analyze correlation between spinal-pelvic parameters and between spinal-pelvic parameters and anatomical parameters in both AIS patients and normal controls. PT was significantly lower in AIS patients than in normal controls (P < 0.05), whereas no significant difference was found in the other spinal-pelvic parameters, i. e. , LL, PI, and SS. There was a significant difference in PT between sexes in AIS patients. SS was significantly correlated with LL in EIA patients (P < 0.05, r > 0.5). SS was significantly correlated with LL and PI, and PT with LL, PI, and SS in normal controls (all P < 0.05), and there was no significant correlation between the other sagittal spinal-pelvic parameters (P > 0.05). FH-S was significantly correlated with LL, PI, SS, and PT in AIS patients (all P < 0.05). AIS affects some of the sagittal spinalpelvic parameters and anatomical parameters. In AIS, there is a significant correlation between the spinal-pelvic parameters, and the anatomical parameter is significantly correlated with multiple spinal-pelvic parameters.

Este estudio tuvo como objetivo investigar los cambios morfológicos sagitales de la columna vertebral-pélvica, así como la relación entre los cambios anatómicos pélvicos y el plano espinal-pélvico en pacientes con escoliosis idiopática adolescente (EIA), con el fin de proporcionar pautas para la cirugía ortopédica en AIS. Se obtuvieron los datos de rayos X para el análisis retrospectivo de 30 pacientes diagnosticados como EIA en los Departamentos de Radiología del hospital Second Affiliated Hospital of Inner Mongolia Medical University y el hospital Inner Mongolia International Mongolian Medical Hospital, desde abril de 2014 hasta noviembre del 2018, junto con 30 adolescentes normales como control. Se midieron los parámetros pélvicos, que incluyeron incidencia pélvica (IP), inclinación pélvica (P) y pendiente sacra (PS), un parámetro espinal, lordosis lumbar (LL) y parámetros anatómicos, que incluyeron el ancho sacro (AS) y la distancia del sacro cabeza femoral (FH-S). Los parámetros espinalpélvicos se compararon entre los pacientes con EIA y los controles normales, como también entre pacientes con EIA masculinos y femeninos. La correlación de Pearson se realizó para analizar la correlación entre los parámetros espinal-pélvicos y entre los parámetros espinal-pélvicos y los parámetros anatómicos tanto en pacientes con EIA como en controles normales. PT fue significativamente menor en pacientes con EIA que en los controles normales (P <0,05), mientras que no se encontraron diferencias significativas en los otros parámetros espinal-pélvicos, i. mi. , LL, PI y SS. Hubo una diferencia significativa en PT en pacientes de ambos sexos con EIA. SS se correlacionó significativamente con LL en pacientes con EIA (P <0,05, r> 0,5). SS se correlacionó significativamente con LL y PI, y PT con LL, PI y SS en controles normales (todos P <0,05), y no hubo correlación significativa entre los otros parámetros sagitales de la columna vertebral-pélvica (P> 0,05) FH-S se correlacionó significativamente con LL, PI, SS y PT en pacientes con EIA (todos P <0,05). EIA afecta algunos de los parámetros sagitales de la columna vertebral-pélvica y los parámetros anatómicos. En EIA, existe una correlación significativa entre los parámetros espinal-pélvicos, y el parámetro anatómico se correlaciona significativamente con múltiples parámetros espinales-pélvicos.

Humans , Male , Female , Adolescent , Pelvic Bones/anatomy & histology , Scoliosis/pathology , Spine/anatomy & histology
Rev. bras. ortop ; 55(1): 62-69, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1092668


Abstract Objective To determine the anatomical parameters of the atlas (C1) in a sample of the Brazilian population and compare them with the results already presented in the literature for other populations and, thus, to identify and change the indications of implants used in the treatment of the upper cervical spine. Methods We performed a retrospective observational study of a prospective database, including 100 patients seen between January 2012 and December 2013. We used axial and sagittal sections of computed tomography (CT) scans. The parameters studied were; axial: distance from posterior tubercle to the screw entry point (DPT_EP), safety angle of the axial screw (SA_AS), ideal axial screw length (_ASL) and distance of the spinal canal from the transverse foramen (DSC_TF); Sagittal: ideal sagittal screw length (_SSL), safety angle of the sagittal screw (SA_SS) and posterior arch thickness (_PAT). All of the parameters were divided according to age, gender, and left and right sides. Results The minimum mean point of entry ranged from 20 mm to 22.7 mm. The average security zone ranged from 18.09º to 23.68º. The mean posterior arch thickness ranged from 7.21 mm to 8.95 mm. The lowest averages were found in females. Using an original and reproducible technique of CT evaluation. Conclusion The anatomical parameters of the atlas found in the sample of the studied population were similar to those previously presented in the literature. However, differences between the sexes were observed.

Resumo Objetivo Determinar os parâmetros anatômicos do atlas (C1) em uma amostra da população brasileira, compará-los aos resultados já apresentados na literatura para outras populações e, assim, identificar e alterar as indicações dos implantes utilizados no tratamento das afecções da coluna cervical alta. Métodos Foi realizado um estudo observacional retrospectivo de um banco de dados prospectivo, incluindo 100 pacientes atendidos entre janeiro de 2012 a dezembro de 2013. Foram utilizados cortes axiais e sagitais de tomografias computadorizadas (TCs). Os parâmetros estudados foram; axial: ponto de entrada do parafuso (DTPPE), ângulo de segurança (ADSPA), tamanho ideal do parafuso (TPA) e tamanho da massa lateral entre os forames vertebral e transverso (DCVFT); sagital: tamanho ideal do parafuso (TPS), ângulo de segurança (ADSPS) e espessura do arco posterior (EAP). Todos os parâmetros foram divididos de acordo com a idade, gênero e lado esquerdo e direito. Resultados A média mínima do ponto de entrada variou de 20 mm a 22,7 mm. A zona de segurança média variou de 18,09º a 23,68º. A espessura média do arco posterior variou entre 7,21 mm e 8,95 mm. As menores médias foram encontradas no sexo feminino. Por meio de uma técnica original e reprodutível de avaliação de TC. Conclusão Os parâmetros anatômicos do atlas encontrados na amostra da população estudada foram semelhantes aos apresentados previamente na literatura. No entanto, foram observadas diferenças entre os sexos.

Spine/anatomy & histology , Tomography , Tomography, X-Ray Computed , Atlas
Rev. medica electron ; 41(6): 1341-1353, oct.-dic. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1094134


RESUMEN Introducción: los estudios actuales sobre la caracterización antropométrica de las vértebras, reviste importancia para las especialidades de Ortopedia y Neurocirugía por el interés quirúrgico que tiene este conocimiento. Objetivo: caracterizar las dimensiones antropométricas de las vértebras cervicales pertenecientes a la Osteoteca de la Universidad de Ciencias Médicas de Matanzas. Materiales y métodos: se realizó un estudio descriptivo, observacional. El universo de estudio estuvo integrado por 63 vértebras cervicales existentes en la Osteoteca. Se realizaron medidas del cuerpo, agujero vertebral, agujeros transversos y forma de los mismos. Resultados: los valores de las medidas del cuerpo vertebral mostraron un predominio de la media del diámetro transversal con 24,24 mm, sobre el anteroposterior de 15,57 mm. El diámetro transversal del agujero vertebral, midió 25,70 mm y el anteroposterior fue menor con 17,06 mm. Al estudiar la forma de los agujeros transversos, en total predominó el tipo redondo; mientras que al compararlos según lateralidad, en el lado izquierdo predominó el tipo redondo, mientras que en el derecho fue el tipo oval paralelo. Se observó en ambos agujeros transversos el predominio del diámetro transverso sobre el paralelo y comparando los agujeros entre sí, se oapreció una media mayor de ambos diámetros en los agujeros del lado izquierdo. Conclusiones: existió un predominio del diámetro transversal en el cuerpo y el agujero vertebral. Es más frecuente el tipo de agujero transverso redondo y los agujeros izquierdos presentaron mayores dimensiones (AU).

ABSTRACT Introduction: current studies on vertebras anthropometric characterization are of great importance for the specialties of Orthopedics and Neurosurgery due to the surgical interest of this knowledge. Objective: to characterize the anthropometric dimensions of the cervical vertebras belonging to the Osteotheque of the University of Medical Sciences of Matanzas. Materials and Methods: an observational, descriptive study was carried out. The universe of study was integrated by 63 cervical vertebras kept in the Osteotheque. Measures of the body, vertebral foramen and foramen transversarium were taken and their form was described. Results: the values of the vertebral body measures showed the predominance of the average transverse diameter with 24.24 mm, over the anterior-posterior one of 15.57 mm. The transverse diameter of the vertebral foramen was 25.70 mm, and the anterior-posterior one was 17.06 mm. When studying the form of the transverse foramens, in general the round kind predominated; at the comparison according to laterality, the round kind predominated in the left side while in the right the oval parallel one predominated. In both foramens transversaria the predominance of the transverse diameter over the parallel one was observed and when comparing both foramens, a higher diameter average was found in the left side foramens. Conclusions: there is a predominance of the transverse diameter in the body and vertebral foramen. The most frequent foramen was the round transverse one and left foramens had higher dimensions (AU).

Humans , Spine/anatomy & histology , Universities , Cervical Vertebrae/anatomy & histology , Anthropometry , Libraries, Special , Orthopedics , Specialties, Surgical , Epidemiology, Descriptive , Observational Study , Medicine , Neurosurgery
Rev. cuba. obstet. ginecol ; 45(3): e487, jul.-set. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093661


Introducción: La hemivértebra es un raro defecto congénito de la columna vertebral fetal en la que solo se desarrolla el cuerpo vertebral de un lado, lo cual provoca su deformidad. Objetivo: Presentar un caso con diagnóstico ecográfico tridimensional prenatal de hemivértebra, como único defecto. Método: Se realizó evaluación ecográfica prenatal y examen anátomo patológico y radiológico posmortem al feto con escoliosis congénita provocado por hemivértebra. Se revisó la literatura sobre este defecto congénito, su diagnóstico prenatal y otros aspectos genéticos que deben tenerse en cuenta para el asesoramiento a la familia. Presentación de caso: Gestante de 28 años remitida a la consulta provincial de Genética Médica en la ciudad de Camagüey, Cuba, el 25 de septiembre del 2018, por sospecha ultrasonográfica de hemivértebra fetal con 20 semanas de gestación. Se confirma diagnóstico a esta instancia, mediante ultrasonografía tridimensional. Con el consentimiento familiar informado se realiza interrupción de la gestación y se comprueba el diagnóstico prenatal realizado por estudios radiológicos y anátomo patológico de la región dorso lumbar. Conclusiones: Se concluye como un defecto congénito múltiple, aislado, de posible etiología multifactorial. Se destacó el valor de la ecografía tridimensional, vista sagital coronal, como método no invasivo más empleado para el diagnóstico prenatal(AU)

Introduction: The hemivertebrae is a rare congenital defect of the fetal spine in which only the vertebral body develops on one side, resulting in deformity. Objective: To present a case with three-dimensional prenatal ultrasound diagnosis of hemivertebrae, as the only defect. Method: Prenatal ultrasound evaluation, postmortem anatomopathological and radiological examination were performed in a fetus with congenital scoliosis caused by hemivertebrae. The literature on this congenital defect, the prenatal diagnosis and other genetic aspects that should be taken into account for family counseling was reviewed. Case report: A 28-year-old pregnant woman referred to the provincial office of Medical Genetics in Camagüey, Cuba, on September 25, 2018, due to ultrasonographic suspicion of fetal hemivertebrae. She was 20 weeks of gestation. Diagnosis is confirmed by three-dimensional ultrasonography. After the informed family consent, the pregnancy was interrupted. The prenatal diagnosis was verified by radiological and pathological studies of the lumbar back region. Conclusions: It is concluded as a multiple congenital defect, isolated, of possible multifactorial etiology. The value of three-dimensional ultrasound, coronal sagittal view, was highlighted as the most commonly used, non-invasive method for prenatal diagnosis(AU)

Humans , Female , Pregnancy , Adult , Ultrasonography, Prenatal/methods , Spine/anatomy & histology , Spine/abnormalities , Spine/diagnostic imaging , Anatomy, Cross-Sectional/methods
Rev. bras. ciênc. vet ; 26(1): 17-20, jan.-mar. 2019. il.
Article in English | LILACS, VETINDEX | ID: biblio-1391664


Feline night monkey (Aotus azarae infulatus) is an arboreal primate that sleeps during the day hidden among branches of trees, leaving its hideout after nightfall. Little is known about the morphology of these animals, which leads to some difficulty in clinical and surgical approaches, as there has been substantial growth in the veterinarian's role in maintaining the health and well-being of wildlife. Thus, we sought to investigate the topography and morphometry of the medullary cone, a small portion of the nervous system of the feline night monkey, which is of paramount importance in approaches for epidural anesthesia. Specimens from five young females were used, each with eight lumbar vertebrae, three sacral vertebrae, and a medullary cone with an average length of 7.5 cm, located between L5 and S3. Based on this finding, we suggest that a probable site for the application of epidural anesthesia is the space between S3 and Cc1.

O macaco-da-noite (Aotus azarae infulatus) é um animal arborícola que dorme durante o dia escondido entre os ramos, saindo do esconderijo após o anoitecer. Pouco se sabe sobre a morfologia destes animais, o que gera certa dificuldade nas abordagens clínico-cirúrgicas, uma vez que cresce substancialmente o papel do médico veterinário nas questões de saúde e bem-estar de animais selvagens. Visando contribuir com esses profissionais, buscou-se investigar a topografia e morfometria de uma pequena porção do sistema nervoso do macaco-da-noite, o cone medular, que é de suma importância nas abordagens quanto à anestesia peridural. Foram utilizados cinco espécimes fêmeas, jovens, de macaco-da-noite, que apresentavam oito vértebras lombares e três vértebras sacrais, e cone medular possuindo em média de 7,5 cm de comprimento, localizando-se entre L5 e S3. Este achado nos leva a sugerir como sítio provável para a aplicação de anestesia epidural, o espaço entre S3 e Cc1.

Animals , Spinal Cord/anatomy & histology , Spine/anatomy & histology , Aotidae/anatomy & histology , Dissection/veterinary , Anesthesia, Caudal/veterinary , Anesthesia, Epidural/veterinary , Macaca/anatomy & histology , Animals, Wild/anatomy & histology
Clinics ; 73: e647, 2018. tab, graf
Article in English | LILACS | ID: biblio-974938


OBJECTIVES: The purpose of this study is to investigate the normal values of and chain of correlations between spinopelvic parameters in a Brazilian population. METHODS: This is a prospective observational study including asymptomatic adult subjects who had full spinal radiographs performed. The subjects were stratified by age into 3 groups (18-39 years old, 40-59 years old, and >60 years old), and radiographic parameters were compared across age groups and gender using ANOVA and Student's t-test, respectively. The relationships between various radiographic parameters were evaluated with Pearson correlation coefficients. RESULTS: One hundred and thirty asymptomatic volunteers (mean age, 48 years) met the inclusion criteria. The mean sagittal parameters in a normal Brazilian population were as follows: lumbar lordosis (LL) of 56.8°, pelvic tilt (PT) of 12.4°, pelvic incidence (PI) of 49.4°, PI-LL of -7.4°, T1 pelvic angle (TPA) of 8°, sagittal vertical axis (SVA) of -0.54 cm and T1 slope of 25.2°. Subjects ≥60 years old had significantly higher values of SVA (p=0.024) and TPA (p=0.009) than the two younger age groups. The TPA was significantly correlated with the following spinopelvic parameters: LL (r=-0.172, p=0.005), PT (r=0.776, p<0.001), PI (r=0.508, p<0.001), PI-LL (r=0.717, p<0.001), SVA (r=0.409, p<0.001) and T1 slope (r=0.172, p=0.050). CONCLUSION: This study demonstrated significant physiologic trunk inclination with increasing age. The TPA, an angular parameter of global spinal alignment, presented a chain of correlations with different spinal segments.

Humans , Adolescent , Adult , Middle Aged , Aged , Young Adult , Spine/diagnostic imaging , Posture , Reference Values , Spine/anatomy & histology , Brazil , Radiography , Prospective Studies
Coluna/Columna ; 16(2): 109-111, Apr.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-890889


ABSTRACT Objective: To determine the morphology of the vertebral foramen and its distance to the midline. Methods: Twenty cervical CT scans from the radiographic record of 12 men and 8 women, 18 to 74 years old, of C1 to C6 segments were evaluated, measuring the foramen diameter and its distance to the midline. We look for anomalies of vertebral foramen morphology, using Philips Ingenuity CT equipment with Philips IntelliSpace Portal software. Results: The mean age was 47 years; the segment with the most anomalies was C1, with 10% (increase in foramen diameter), followed by C2 and C6, with 5% (vertebral foramen hypotrophy); the mean diameter of the C1 to C6 segment was 6.081 mm, and the median distance from the midline to the vertebral foramen of C2 to C6 was 13.215 mm. The largest diameter of the vertebral foramen was C2, with a mean of 6.67 mm and the smallest was C4, with a mean of 5.75 mm; the greatest distance from the midline to the vertebral foramen was C1, with a mean of 22.59 mm and the shortest was C4, with a mean of 12.13 mm. Conclusions: The mean diameter of the vertebral foramen and its distance to the midline was determined, setting a safety region for procedures. In our city, there is no study that determines the means of the vertebral foramina diameters, the distance from the midline and its anomalies. It is necessary to rely on CT scans and to make a preoperative plan to avoid complications associated with morphological alterations.

RESUMO Objetivo: Determinar a morfologia do forame vertebral e sua distância da linha mediana. Métodos: Foram avaliadas 20 tomografias cervicais do arquivo radiográfico de 12 homens e 8 mulheres, de 18 a 74 anos de idade, dos segmentos C1 a C6, fazendo a medição do diâmetro do forame e de sua distância até a linha mediana. Buscaram-se as anomalias da morfologia do forame vertebral, usando um equipamento Philips Ingenuity CT com o software Philips IntelliSpace Portal. Resultados: A média de idade foi 47 anos; o segmento com mais anomalias foi C1, com 10% (aumento do diâmetro do forame), seguido por C2 e C6, com 5% (hipotrofia do forame vertebral); o diâmetro médio do segmento C1 a C6 foi 6,081 mm e a distância média da linha mediana até o forame vertebral de C2 a C6 foi 13,215 mm. O maior diâmetro do forame vertebral foi C2, com média de 6,67 mm e o menor foi C4, com média de 5,75 mm; a maior distância da linha mediana até o forame vertebral foi a de C1, com média de 22,59 mm e a menor foi em C4, com média de 12,13 mm. Conclusões: Foi determinada a média do diâmetro do forame vertebral e sua distância até a linha mediana, estabelecendo-se uma região de segurança para procedimentos. Em nossa cidade, não há um estudo que determine a médias dos diâmetros do forame vertebral, a distância da linha mediana e suas anomalias. É preciso contar com a tomografia e fazer um plano pré-operatório para evitar as complicações associadas às alterações morfológicas.

RESUMEN Objetivo: Determinar la morfología del foramen vertebral y su distancia de la línea media. Métodos: Se evaluaron 20 tomografías cervicales, del archivo radiográfico de 12 hombres y 8 mujeres, de 18 a 74 años de edad, del segmento C1 a C6, realizando la medición del diámetro del foramen, y su distancia de la línea media. Se buscaron las anomalías morfológicas del foramen vertebral, usando un equipo Philips Ingenuity CT y software Philips IntelliSpace Portal. Resultados: La edad promedio fue de 47 años; el segmento con más anomalías fue C1, con 10% (aumento del diámetro del foramen), seguido de C2 y C6 con 5% (hipotrofia del foramen vertebral); el promedio del diámetro del segmento C1 a C6 fue de 6,081 mm y el promedio de distancia de la línea media al foramen vertebral de C2 a C6 fue 13,215 mm. El mayor diámetro del foramen vertebral fue en C2, con promedio de 6,67 mm y el menor fue en C4 con promedio de 5,75 mm; la mayor distancia de línea media al foramen vertebral correspondió en C1 con promedio de 22,59 mm y la menor fue en C4 con promedio de 12,13 mm. Conclusiones: Se determinó el promedio del diámetro del foramen vertebral y su distancia a la línea media, estableciendo una zona de seguridad para procedimientos. En nuestra ciudad no existe un estudio que determine promedios del diámetro del foramen vertebral, la distancia desde la línea media y sus anomalías. Es preciso contar con tomografía y hacer un plan preoperatorio para evitar las complicaciones asociadas con alteraciones morfológicas.

Humans , Spine/anatomy & histology , Spinal Canal , Diagnostic Imaging , Tomography, X-Ray Computed
Coluna/Columna ; 15(3): 205-208, July-Sept. 2016. tab, graf
Article in English | LILACS | ID: lil-795021


ABSTRACT Objective: The anatomical study of the vertebrae C7 and T1 of the cervicothoracic junction aimed to evaluate quantitatively, by axial computerized tomography (CT), the linear and angular dimensions of the anatomical laminae of the vertebrae of the cervicothoracic junction C7 and T1 in adults over 18 years. Methods: We retrospectively analyzed 49 CT of the cervical and thoracic spine (C7 and T1) of individuals over 18 years, of both sexes. We also evaluated the length and thickness of the laminae, as well as spinolaminar angle in axial sections of C7 and T1 at the point of least thickness between the inner cortical layers. The variables were correlated with age groups and sex of the individuals. Statistical analysis was performed using the t test and the results were considered significant when p<0.05. Results: After analyzing tomographic measurements of 49 patients, it was found that men had greater laminae thickness than women, both in C7 and T1, with 71% of C7 laminae and 92% of T1 laminae thicker than 5mm, and 97% of C7 laminae and 100% of T1 thicker than 4mm. The mean spinolaminar angle was 56.40 degrees in C7 and 57.31 degrees in T1. Conclusion: This study brings important anatomical information about the cervicothoracic junction C7 and T1 in the Brazilian population, showing that fixation of C7 and T1 with intralaminar screws is anatomically possible.

RESUMO Objetivo: O estudo anatômico das vértebras da transição cervicotorácica C7 e T1 teve como objetivo avaliar quantitativamente, por tomografia computadorizada axial (TC), as dimensões anatômicas lineares e angulares de lâminas das vértebras da transição cervicotorácica C7 e T1 em indivíduos adultos maiores de 18 anos. Métodos: Foram analisadas retrospectivamente 49 TC da coluna cervical e torácica (C7 e T1) de indivíduos maiores de 18 anos, de ambos os sexos. Avaliaram-se o comprimento e a espessura das lâminas, bem como o ângulo espinolaminar, em cortes axiais de C7 e T1, no ponto de menor espessura entre as camadas corticais internas. As variáveis estudadas foram correlacionadas com os grupos etários e o sexo dos indivíduos. A análise estatística foi feita pelo teste t e os resultados foram considerados significativos quando p < 0,05. Resultados: Após análise de medidas tomográficas de 49 pacientes, foi verificado que os homens apresentaram espessura de lâmina maior que as mulheres tanto em C7, quanto em T1, sendo que 71% das lâminas de C7 e 92% das lâminas de T1 apresentavam espessura maior que 5 mm e 97% das lâminas de C7 e 100% de T1, espessura maior que 4 mm. O ângulo espinolaminar apresentou média de 56,40 graus em C7 e 57,31 graus em T1. Conclusão: O estudo traz informações anatômicas importantes sobre a região da transição cervicotorácica C7 e T1 na população brasileira, mostrando ser possível anatomicamente, fixação de C7 e T1 com parafuso intralaminar.

RESUMEN Objetivo: El estudio anatómico de las vértebras de la unión cervicotorácica C7 y T1 tuvo el objetivo de evaluar cuantitativamente mediante tomografía axial computarizada (TAC), las dimensiones anatómicas lineales y angulares de láminas de las vértebras de la unión cervicotorácica C7 y T1 en adultos mayores de 18 años. Métodos: Se analizaron retrospectivamente 49 TAC de la columna cervical y torácica (C7 y T1) de pacientes mayores de 18 años de ambos sexos. Se evaluaron la longitud y el espesor de las láminas, así como el ángulo espinolaminar en secciones axiales de C7 y T1 en el punto de menor espesor entre las capas corticales internas. Las variables se correlacionaron con los grupos de edad y sexo de los individuos. El análisis estadístico se realizó mediante la prueba t y los resultados se consideraron significativos cuando p < 0,05. Resultados: Después del análisis de las mediciones tomográficas de 49 pacientes, se encontró que los hombres tenían espesor de la lámina mayor que las mujeres, tanto en C7, como en T1, con el 71% de las láminas C7 y el 92% de las láminas T1 con espesor mayor que 5 mm, 97% de C7 y 100% de T1, mayor que 4 mm de espesor. El ángulo espinolaminar promedio fue 56,40 grados en C7 y 57,31 grados en T1. Conclusión: Este estudio contiene información anatómica importante sobre la región de la unión cervicotorácica C7 y T1 en la población brasileña, mostrando que es anatómicamente posible la fijación de C7 y T1 con tornillos intralaminares.

Humans , Spine/anatomy & histology , Spine/diagnostic imaging , Tomography, X-Ray Computed , Cervical Vertebrae
Int. j. morphol ; 34(1): 168-178, Mar. 2016. ilus
Article in English | LILACS | ID: lil-780491


The aim of the present study was focused on and describes the gross morphological and scanning electron microscopical features of the gill of the red swamp freshwater crayfish. Our results noted that: all gills have the same general structure and appearance. The gill consists of axis with numerous finger-like filaments, having three morphological types; round, pointed and somewhat hooked shaped. There is a variation in the direction of filaments according to their position, in middle part were nearly perpendicular to gill axis while in the apex were nearly parallel to axis. There were characteristic system of gill spines on central axis, basal plate, setobranch and on the bilobed epipodal plate. There are four shape of spinated-like parts of setobranch seta, two pointed processes and two broad processes. The bilobed epipodal plate is devoid from any filaments and under SEM, its apical part has serrated free border and corrugated surface while the middle part has no serrated free border.

El objetivo del presente estudio fue describir las características morfológicas macroscópicas y mediante microscopio electrónico de barrido las branquias del cangrejo rojo de pantano de agua dulce. Nuestros resultados señalan que todas las branquias tienen la misma estructura y apariencia general. Las branquias se componen de ejes con numerosos filamentos similares a dedos, que tiene tres tipos morfológicos; redondo, punteado y con forma de gancho. Hay una variación en la dirección de los filamentos de acuerdo con su posición, en la parte media eran casi perpendicular al eje branquial, mientras que en el ápice fueron casi paralelas al eje. Hubo un sistema característico de espinas branquiales sobre el eje central, placa basal, espinas dorsales y sobre las placas epipodales bilobuladas. Se observaron cuatro formas de las ramas similares a espinas, dos procesos apuntados y dos procesos amplios. La placa epipodal bilobulada estaba desprovista de filamentos bajo microscopía electrónicas, su parte apical tiene una margen libre aserrado, con una superficie ondulada, mientras que la parte media no tiene margenes aserrados.

Animals , Astacoidea/anatomy & histology , Gills/anatomy & histology , Egypt , Spine/anatomy & histology
Actual. osteol ; 12(3): 180-187, 2016. graf, ilus, tab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1370793


La densidad mineral ósea (DMO) por tomografía computarizada cuantitativa (QCT) mide con exactitud y precisión de corto plazo la densidad volumétrica (DMOv) de secciones axiales de los cuerpos vertebrales lumbares valiéndose de un fantoma de calibración. Existe evidencia de que la densitometría por TC sin fantoma convirtiendo las unidades Hounsfield en g/cm3 aplicando un coeficiente específico para cada equipo, presenta muy alta correlación con la DMO por QCT y que es confiable para evaluar la densidad ósea vertebral. Apoyándonos en ello, correlacionamos DMO y CMO estimados a partir de estudios de TC con los obtenidos por DXA. Se incluyeron 28 mujeres (edad: 63,4±10,3 años, rango: 37-85) que habían realizado una TC de abdomen y previamente una DMO en un lapso previo no mayor de 6 meses. Se midieron: 1) TC: DMOv promedio integral (trabecular + cortical) en un corte axial medio vertebral de 10 mm de espesor y el área en cm2 . Se multiplicó la densidad por el área, obteniendo un valor equivalente al CMO de la sección (CMO-TC) y 2) DXA: se consideraron la DMOa y CMO en una RI de 10 mm de altura a nivel del centro de la vértebra L3. Las correlaciones entre los parámetros homólogos obtenidos por ambos métodos fueron significativas: resultó superior para CMO [DMOv vs. DMOa r: 0,67 (p=0,005) y CMO-TC vs. CMO-DXA r: 0,75 (p=0,00063)]. El estudio complementa los ya existentes y abre la posibilidad de utilizar estudios de rutina de TC de abdomen para evaluar la densidad ósea, para lo cual deberán establecerse valores de referencia sexo y edad específicos. (AU)

Conventional quantitative computed tomography (QCT) uses a calibration phantom scanned simultaneously with the anatomical region of interest and measures bone density accurately and with short-term high precision. Evidence supports that phantom-less volumetric BMD highly correlates with QCT BMD and is a reliable method for assessing bone density of vertebral bodies. Assessment of BMD in routine abdominal CT scans has been investigated in recent years. The aim of the study was to correlate BMD and bone mineral content (BMC) obtained from CT studies with data obtained by DXA. Twenty eight women (age 63.4±10.3 years old, range: 37-85) who underwent abdominal CT for different reasons and DXA measurements within 6 months were included. A simple manual region of interest (RI) which delineated the edge of the vertebral body was applied to L3. We measured 1) CT: Volumetric integral density (BMDv) -trabecular and cortical bone- of the axial section and area (A) in cm2 . Density was multiplied by area to obtain a value equivalent to BMC. 2) DXA: BMD and BMC in a RI of 10 mm height in the middle of L3. All parameters obtained by CT correlated significantly with the corresponding to DXA : BMDv vs BMDa r: 0.67 (p=0.005) y BMC-CT vs BMC-DXA: r: 0.75 (p=0.00063). This study complements previous reports and opens the possibility of using routine abdominal CT studies to assess bone density. For that purpose reference values (age and gender) must be established. (AU)

Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Spine/diagnostic imaging , Tomography, X-Ray Computed/instrumentation , Tomography, X-Ray Computed/methods , Bone Density , Densitometry/instrumentation , Densitometry/methods , Osteoporosis/prevention & control , Osteoporosis/diagnostic imaging , Spine/anatomy & histology , Sex Factors , Data Interpretation, Statistical , Age Factors , Phantoms, Imaging , Abdomen/diagnostic imaging
Coluna/Columna ; 14(4): 304-307, Oct.-Dec. 2015. graf
Article in English | LILACS | ID: lil-770234


Objective : Tomographic analysis of the T1 vertebra in children from 0 to 12 years of age, in order to obtain anatomical parameters that assist intralaminar fixation in this pediatric population. Methods : Retrospectively analysis of the spine with CT (cervical and thoracic) of individuals aged between 0 and 12 years old, of both sexes, without anatomical deformities. The CT scans were evaluated separately, on each side, for length and thickness of the laminas as well as spinolaminar angle. The morphometric analysis was performed with iSite PACS Philips Healthcare Informatics(r) program and the values were expressed in millimeters (mm). The variables were correlated with age groups and sex of individuals. Statistical analysis was performed using t test and the results were considered significant when p<0.05. Results : By means of tomographic analysis of 24 patients it was found that age has no correlation with the angle of attack for intralaminar screws T1. However, the length and thickness of the T1 lamina increase proportionally with age. The total average length of the laminas was 28.62 ± 4.42 mm. The total average thickness was 4.75 ± 0.95 mm (3.2 to 6.5). Conclusion : This study shows relevant data on the use of Tran laminar screws currently commercially available with a minimum thickness of 3.5 mm. It is thus possible to say in this sample, they can be used in 87.5% of all laminas, being applicable in all lamina in patients older than 44 months of age.

Objetivo : Análise tomográfica da vértebra T1 em crianças de zero a doze anos de idade, obtendo parâmetros anatômicos que auxiliarão a fixação intralaminar nessa população infantil. Métodos : Análise retrospectiva da coluna por TC (cervical e torácica) de indivíduos entre 0 e 12 anos de idade, de ambos os sexos, sem deformidades anatômicas. Foram avaliados, separadamente, em cada lado, o comprimento e a espessura das lâminas, bem como o ângulo espino-laminar. A análise morfométrica foi realizada com o programa iSite PACS Philips Healthcare Informatics(r) e os valores obtidos foram expressos em milímetros (mm). As variáveis estudadas foram correlacionadas com os grupos etários e o sexo dos indivíduos. A análise estatística foi feita pelo teste t e os resultados foram considerados significativos quando p < 0,05. Resultados : Por meio de análises tomográficas de 24 pacientes, verificou-se que a idade não tem correlação com o ângulo de ataque para parafusos intralaminares de T1. Já o comprimento e a espessura da lâmina de T1 aumentam proporcionalmente com a idade. O comprimento médio total das lâminas foi de 28,62 ± 4,42 mm. A média total da espessura 4,75 ± 0,95 mm (3,2 a 6,5). Conclusão : O presente estudo mostra dados relevantes sobre a utilização de parafusos translaminares, que atualmente são disponíveis comercialmente com espessura mínima de 3,5 mm. É possível, assim, afirmar que, nesta amostra, pode ser utilizado em 87,5% do total de lâminas, sendo aplicável em todas as lâminas nos pacientes acima de 44 meses de idade.

Objetivo : Análisis tomográfico de la vértebra T1 en niños de cero a doce años de edad, para obtener parámetros anatómicos que ayudarán la fijación con tornillos intralaminares en esta población infantil. Métodos : Análisis retrospectivo de la columna por TAC (cervical y torácica) de individuos entre 0 y 12 años de edad, de ambos sexos, sin deformidades anatómicas. Se evaluaron por separado, en cada lado, la longitud y el grosor de las láminas, así como el ángulo espinolaminar. El análisis morfométrico se realizó con el programa iSite PACS Philips Healthcare Informatics(r) y los valores se expresaron en milímetros (mm). Las variables se correlacionaron con los grupos de edad y sexo de los individuos. Se realizó un análisis estadístico mediante la prueba t y los resultados se consideraron significativos cuando p < 0,05. Resultados : Por medio de análisis tomográficos de 24 pacientes, se encontró que la edad no se correlaciona con el ángulo de ataque para tornillos intralaminares T1. Sin embargo, la longitud y el grosor de la lámina T1 aumentan proporcionalmente con la edad. La longitud promedio total de las láminas fue 28,62 ± 4,42 mm. El espesor promedio total fue 4,75 ± 0,95 mm (3,2 a 6,5). Conclusión : Este estudio muestra datos relevantes sobre el uso de tornillos translaminares que actualmente están disponibles en el mercado con un espesor mínimo de 3,5 mm. Por tanto, es posible afirmar que, en esta muestra, se puede utilizarlos en el 87,5% de todas las láminas siendo aplicable en todas las láminas de pacientes mayores de 44 meses de edad.

Humans , Infant, Newborn , Infant , Child, Preschool , Child , Laminectomy , Spine/anatomy & histology , Bone Screws , Tomography, X-Ray Computed
Rev. bras. ortop ; 50(4): 438-444, July-Aug. 2015. tab, ilus
Article in English | LILACS | ID: lil-761109


Verificar a prevalência dos tipos de fórmula metatarsal (FM) em pacientes com metatarsalgia primária (MP); comparar a variável "encurtamento do primeiro metatarso em relação ao segundo" (I/II) entre os grupos metatarsalgia (GM) e controle (GC); analisar a concordância intra e interobservadores pelos métodos das linhas transversais (MLT) de Morton e dos arcos (MA) de Hardy e Clapham. MÉTODOS: Estudo observacional transversal em 56 pacientes por meio de radiografias dos 112 pés, 56 do GM e 56 do GC avaliados entre dezembro de 2012 e junho de 2013. As mensurações foram feitas por três residentes do terceiro ano em ortopedia, com treinamento prévio dos métodos e uso de template. RESULTADOS: Não houve concordância em nenhum dos dois métodos verificados pelos gráficos de Bland-Altman, apesar de o coeficiente de correlação intraclasses apresentar uma alta reprodutibilidade intra e interobservadores pelo MLT (0,78 e 0,85) e moderada pelo MA (0,73 e 0,60). Na comparação entre os grupos, observou-se diferença estatística (p ≤ 0,05) com um encurtamento do primeiro metatarso (3,39 mm) maior no GC em relação ao GM (2,14 mm). Nos pacientes com MP, a FM tipo index minusfoi mais prevalente pelo MLT (62,5%) e o tipo zero pluspelo MA (71,4%). CONCLUSÃO: Foi observado que a prevalência da FM depende do método de mensuração. Em ambos os grupos houve predomínio do encurtamento do primeiro metatarso. Não houve concordância intra e interobservadores em nenhum dos métodos propostos.

The aims of this study were (i) to ascertain the prevalence of different types of metatarsal formula among patients with primary metatarsalgia; (ii) to compare the variable of "shortening of the first metatarsal in relation to the second" (I/II) between the metatarsalgia and control groups; and (iii) to analyze the intra and interobserver concordance by means of Morton's transverse line method and Hardy and Clapham's arc method. METHODS: A cross-sectional observational study was conducted on 56 patients by means of radiographs on their 112 ft, of which 56 were in the metatarsalgia group and 56 in the control group. The evaluations were done between December 2012 and June 2013. The measurements were made by three third-year orthopedics residents with prior training in the methods used, and a template was used. RESULTS: There was no concordance between the two methods, as shown by Bland-Altman plots, although the intraclass correlation coefficients showed that the intra and interobserver reproducibility was high using the transverse line method (0.78 and 0.85) and moderate using the arc method (0.73 and 0.60). Comparison between the groups showed that there was a statistical difference ( p≤ 0.05) such that there was greater shortening of the first metatarsal (3.39 mm) in the control group than in the metatarsalgia group (2.14 mm). In the patients with primary metatarsalgia, the index minusmetatarsal formula was more prevalent according to the transverse line method (62.5%) and the zero plustype according to the arc method (71.4%). CONCLUSION: In the present study, it was observed that the metatarsal formula prevalences depended on the measurement method. In both groups, shortening of the first metatarsal predominated. There was no intra or interobserver concordance in either of the two proposed methods.

Humans , Cadaver , Spine/anatomy & histology , Ganglia, Spinal , Minimally Invasive Surgical Procedures
Rev. bras. ortop ; 50(4): 450-454, July-Aug. 2015. tab, ilus
Article in English | LILACS | ID: lil-761121


Descrever a localização do gânglio da raiz dorsal em relação ao disco intervertebral, incluindo a zona "triangular"de segurança para cirurgia minimamente invasiva na coluna lombar. MÉTODOS: Oito cadáveres adultos foram dissecados bilateralmente, na região lombar, com a abordagem posterolateral, até exposição dos espaços L3L4 e L4L5 e se obtiveram medidas referentes ao espaço entre o disco intervertebral, os pedículos cranial e caudal ao disco, o trajeto da raiz nervosa, o gânglio dorsal e o triângulo de segurança. RESULTADOS: As medidas obtidas foram constantes, sem diferenças significativas entre níveis ou lateralidade. O gânglio dorsal ocupou a borda lateral da zona triangular de segurança em todos os espécimes analisados. CONCLUSÃO: A localização precisa do gânglio mostra que a margem de segurança para procedimentos minimamente invasivos é menor do que a apresentada nos estudos que envolvem apenas medidas da raiz nervosa, o que explica talvez a presença de dor neuropática após alguns desses procedimentos.

To describe the location of the dorsal root ganglion in relation to the intervertebral disc, including the "triangular" safety zone for minimally invasive surgery in the lumbar spine. METHODS: Eight adult cadavers were dissected bilaterally in the lumbar region, using a posterolateral approach, so as to expose the L3L4 and L4L5 spaces, thereby obtaining measurements relating to the space between the intervertebral disc, pedicles cranial and caudal to the disc, path of the nerve root, dorsal ganglion and safety triangle. RESULTS: The measurements obtained were constant, without significant differences between levels or any laterality. The dorsal ganglion occupied the lateral border of the triangular safety zone in all the specimens analyzed. CONCLUSION: Precise localization of the ganglion shows that the safety margin for minimally invasive procedures is less than what is presented in studies that only involve measurements of the nerve root, thus perhaps explaining the presence of neuropathic pain after some of these procedures.

Spine/anatomy & histology , Ganglia, Spinal , Minimally Invasive Surgical Procedures
Rev. chil. neurocir ; 41(1): 8-13, jul. 2015. ilus
Article in Spanish | LILACS | ID: biblio-836038


En introducción, los autores recuerdan los parámetros clásicos que permiten estudiar la forma sagital de la columna siguiendo una semántica vertebral (lordosis, cifosis, parámetros espino pélvicos, balance sagital). Luego, proponen una perspectiva totalmente diferente que analiza la forma de la columna, no en plano sagital o coronal pero en plano vertical, es decir integrando la gravedad como eje de construcción 3D. Comenzando por un análisis del esquema corporal global (del cual forma parte la columna), se introducen las sinergias musculares utilizando puntos de referencia, definiendo líneas de tensión, arcos anatómicos y funcionales. Resaltan la importancia de la función respiratoria como estabilizador de la forma del raquis toraco-lumbar. Esto demuestra que cuales sean las anomalías pélvicas o vertebrales frecuentes, el esquema biomecánico depende de una ley única vinculada a la gravedad: “La ley del péndulo”. Esto permite definir una columna “ideal” de referencia, comparándola a modelos opuestos. Evocan el interés semántico práctico y terapéutico de una tal perspectiva.

Humans , Biomechanical Phenomena , Spine/anatomy & histology , Lumbosacral Region/physiology , Gravitation , Respiration
Int. j. morphol ; 33(1): 105-112, Mar. 2015. ilus
Article in English | LILACS | ID: lil-743772


Deer and sheep spines are often used as models of the human spine. A prerequisite for the use of animal models is information regarding the interspecies differences in the parameters of general interest. This would clarify the limitations of each animal model and substantiate the applicability of the obtained results to humans. Since sufficient data appear to be currently unavailable, we sought to investigate the feasibility of using deer and sheep as animal models for studies on the human spine. The objective of this study was a thorough comparison of the anatomical parameters of deer and sheep spines with those of the human spine. We employed three-dimensional reconstructions of computed tomography images, generated using figure analysis software, which facilitated quantitative analysis of the linear and curvature parameters and the geometric index of the vertebral bodies. Our findings represent a comprehensive database of the anatomical characteristics of the deer and sheep lumbar spines and their comparisons with those of the human lumbar spine. This study provides insight into the similarities and differences in the vertebral geometries between the human spine and the deer and sheep spines. We found that the differences are minimal and that they do not greatly compromise the utility of deer and sheep lumbar spines as models of the human lumbar spine.

La columna vertebral de ciervos y ovejas se utiliza frecuentemente como modelo de la columna vertebral humana. Un requisito previo para el uso de modelos animales es la información con respecto a las diferencias entre especies en los parámetros de interés general, lo que aclara las limitaciones de cada modelo animal y fundamenta la aplicabilidad de los resultados obtenidos para los seres humanos. Debido a que existen datos suficientes actualmente, hemos intentado investigar la viabilidad de utilizar ciervos y ovejas como modelos animales para los estudios sobre la columna vertebral humana. El objetivo fue realizar una comparación exhaustiva de los parámetros anatómicos de las columnas de ciervos y ovejas, con los de la columna vertebral humana. Empleamos reconstrucciones tridimensionales de imágenes de tomografía computadorizada, mediante un programa de análisis de la figura, lo que facilitó el análisis cuantitativo de los parámetros lineales y de la curvatura y el índice geométrico de las vértebras. Nuestros hallazgos representan una amplia base de datos de las características anatómicas de la columna lumbar de los ciervos y ovejas y sus comparaciones con las de la columna lumbar humana. Este estudio proporciona información sobre las similitudes y diferencias en las geometrías vertebrales entre la columna vertebral humana y las columnas de venado y oveja. Se encontró que las diferencias son mínimas y que no comprometen el uso de la columna de ciervos y ovejas como modelos de la columna lumbar humana.

Humans , Animals , Deer/anatomy & histology , Sheep/anatomy & histology , Spine/anatomy & histology , Anatomy, Comparative , Models, Animal , Spine/diagnostic imaging , Tomography, X-Ray Computed
Int. j. morphol ; 32(4): 1184-1189, Dec. 2014. ilus
Article in English | LILACS | ID: lil-734656


This study aims to carry out a comparative study on the vertebral structure of the elite male weightlifters and the sedentary group (control group) by obtaining three-dimensional data and models by means of photogrammetry from the columna vertebralis sections taken by MDCT. The columna vertebralis of the 8 male weightlifters and 8 sedentary individuals (control group) was scanned with a high-definition diagnostic MDCT device during the study. The demographic findings suggest no difference in both the weightlifters and the sedentary individual. The 2D axial images in DICOM format were burnt on CDs and then copied on a PC on which 3D-Doctor 4.0, which is a 3D modelling program had already been installed. The reconstruction was carried out with the 3D rendering component of the program. All the data were automatically measured by the abovementioned program and the statistical analyses were determined with a ­t test by SPSS 15. Considering the statistical results of the Columna vertebralis, only in the length of Pars lumbaris some statistically considerable differences (p<0.05) were observed between the vertebras L3-L5 in the elite male weightlifters and the sedentary individuals. Therefore, concluding from the idea that these techniques and the three-dimensional reconstruction procedures should be put into practice in the field of sports medicine, the substructure works that will be carried out on weightlifters by means of MDCT are thought to be supported by these studies.

El objetivo fue realizar un estudio comparativo de la estructura vertebral de pesistas de elite y un grupo sedentario (grupo control) através de la obtención de datos y modelos tridimensionales mediante fotogrametría de secciones de la columna vertebral por TCMD. La columna vertebral de los pesistas, 8 varones y 8 sujetos sedentarios (grupo control) fue escaneada con un dispositivo para diagnóstico de alta definición TCMD. Los hallazgos demográficos sugieren que no hay diferencias entre los pesistas y los sujetos sedentarios. Las imágenes axiales 2D en formato DICOM fueron grabados en CD y luego copiadas a un PC en 3D-Doctor 4.0, un programa de modelado 3D que ya se había instalado. La reconstrucción se llevó a cabo con el componente de representación 3D del programa. Todos los datos fueron medidos por el programa de manera automática y los análisis estadísticos fueron determinados mediante una prueba t por SPSS 15.0. Considerando los resultados estadísticos de la columna vertebral, solamente en la longitud de la parte lumbar se observaron algunas diferencias consideradas significativas (p<0,05) entre las vértebras L3-L5 en los pesistas de elite y los sujetos sedentarios. Por lo tanto, estas técnicas y los procedimientos de reconstrucción en tres dimensiones deben ser puestos en práctica en la medicina deportiva, debido a que este tipo de estudio puede ser útil en los trabajos de subestructura que se realizen en los pesistas mediante TCMD.

Humans , Male , Young Adult , Spine/anatomy & histology , Spine/diagnostic imaging , Weight Lifting , Imaging, Three-Dimensional , Multidetector Computed Tomography/methods , Sedentary Behavior
Int. j. morphol ; 32(2): 583-588, jun. 2014. ilus
Article in English | LILACS | ID: lil-714313


The aim of our study was to observe the occurrence rate and morphological characteristics of Infra-Lamina ridge (ILR) in Chinese population and provide a comprehensive reference for its clinical implication. Vertebrae columns of 82 sets of Chinese adult skeletons were collected. The shape of ILR was classified into three types; the occurrence of it in different sides and sexes were counted. The length, width, thickness of ILR were measured using a caliper with 0.02 mm accuracy. The ILR was usually found to occur from C7 to L5, with its frequency higher from T8 to 12, and highest at T10being up to 80.5%. There was significant statistical difference to the occurrence rate by side, sex and vertebral level. The largest values in its length and width were from T9 to T12. The ILR at T10 was largest in dimensions, being 4.1±2.1 mm in length and 4.4±2.3 mm in width. The ILR is more frequently detected in female and at the left side, at the lower thoracic spine with a larger dimension.

El objetivo de nuestro estudio fue observar la tasa de incidencia y características morfológicas del puente infra-laminar (PIL) en la población china y ofrecer una referencia completa por su implicación clínica. Se utilizaron 82 series de vértebras pertenecientes a esqueletos adultos chinos. La forma del PIL se clasificó en tres tipos; además se cuantificó la presenciade la misma en diferentes lados y sexos. La longitud, ancho y grosor del PIL se midieron utilizando un caliper con 0,02 mm de precisión. Se encontró que el PIL por lo general se producía desde C7 a L5 , con una mayor frecuencia entre T8 y T12, la más alta en T10 donde alcanzó el 80,5%. No hubo diferencia estadísticamente significativa en la tasa de ocurrencia según lado, sexo y el nivel de la vértebra. Los mayores valores de longitud y ancho fueron de T9 a T12. El PIL en T10 tuvo las mayores dimensiones, con una longitud de 4,1±2,1 mm y ancho de 4,4±2,3 mm. El PIL se detecta con mayor frecuencia en mujeres y la lado izquierdo, con una mayor dimensión en la columna torácica inferior.

Humans , Male , Female , Adult , Middle Aged , Spine/anatomy & histology , Ossification, Heterotopic , Ligamentum Flavum/anatomy & histology , China
Coluna/Columna ; 13(1): 67-68, Jan-Mar/2014. tab, graf
Article in English | LILACS | ID: lil-709619


Ingestion of foreign bodies is a common problem seen at emergency rooms and frequently involves chicken and fish bones. There are few cases of migrated foreign bodies through the retropharynx causing infectious process in the area but no one, despite the proximity, causing spondylodiscitis. Perhaps such condition is attributed to the integrity of the longus colli fascia covering and protecting the cervical spine. We described the first case of spondylodiscitis due to a foreign body (saw-toothed fish bone) that penetrated the longus colli fascia and carved into vertebral body C3.

A ingestão de corpos estranhos é problema comum nos pronto-socorros e geralmente ocorrem com ossos de aves e espinhas de peixes. Há alguns relatos de casos de migração de corpos estranhos para a retrofaringe, que causam processo infeccioso local, mas não há nenhum caso descrito de espondilodiscite (apesar da proximidade). Talvez a ausência de infecção na coluna vertebral decorra da integridade da fáscia do músculo longo do pescoço, que recobre e protege a coluna cervical. Descrevemos o primeiro caso de espondilodiscite em decorrência de migração de uma espinha serrilhada de peixe que penetrou profundamente na fáscia do músculo longo do pescoço e atingiu o corpo vertebral de C3.

La ingestión de cuerpos extraños es un problema común en los puestos de primeros auxilios y, generalmente, ocurre con huesos de aves y espinas de pescados. Hay algunos relatos de casos de migraciones de cuerpos extraños para la retrofaringe, las cuales causan procesos infecciosos locales, pero no hay ningún caso descrito de espondilodiscitis (aun considerando la proximidad). Quizás la ausencia de infección en la columna vertebral resulte de la integridad de la fascia del músculo largo del cuello, que recubre y protege a la columna cervical. Describimos el primer caso de espondilodiscitis causado por la migración de una espina serrada de pescado, la cual penetró profundamente en la fascia del músculo largo del cuello y alcanzó al cuerpo vertebral de C3.

Humans , Male , Middle Aged , Discitis , Foreign-Body Migration/complications , Spine/anatomy & histology , Fascia
Acta ortop. bras ; 21(4): 195-197, jul.-ago. 2013. ilus, graf, tab
Article in Portuguese | LILACS | ID: lil-684071


Objetivo: Utilizar a análise tomográfica das vértebras C1 e C2 para avaliar a possibilidade do emprego da técnica de Magerl nestes pacientes. Outros objetivos foram obter dados anatômicos para a escolha da técnica cirúrgica de modo geral, estabelecer parâmetros de segurança e obter dados epidemiológicos da população em questão. Métodos: Foram analisados, retrospectivamente, tomografias de 20 pacientes com artrite reumatoide do ambulatório do Grupo de Coluna do IOT-HCFMUSP. Os dados foram analisados estatisticamente para obtenção dos valores médios e da variação de cada medida: do comprimento do pedículo de C2 até a massa lateral de C1, da espessura do pedículo e do ângulo de ataque do parafuso no istmo de C2 com a horizontal. Resultados: Os valores médios encontrados foram respectivamente: lado direito 23,08 mm e esquerdo 23,16 mm; direito 6,46 mm e esquerdo 6,50 mm; direito 44,50O e esquerdo 44,95O. Discussão: os principais fabricantes de parafusos dispõe de implantes compatíveis com as medidas anatômicas encontradas neste trabalho. Considerando a ampla difusão e domínio da técnica de Magerl em nosso meio e no mundo todo, esta é uma opção cirúrgica segura e mecanicamente estável. Conclusão: A técnica de Magerl, segundo análise tomográfica, pode ser empregada nos pacientes com artrite reumatoide. Nível de Evidência IV. Série de Casos.

Objective: To use the tomographic analysis of C1 and C2 vertebrae to assess the possibility of using Magerl’s technique in patients with rheumatoid arthritis. Other objectives were to obtain anatomical data for the choice of the surgical technique in general, to establish safety parameters and obtain epidemiological data of the population in question. Methods: We retrospectively reviewed the CT scans of 20 patients with rheumatoid arthritis of the Outpatient Spine Group, IOT-HCFMUSP. Data were analyzed statistically to obtain the mean values and the variance of each measurement: the length of the C2 pedicle to the C1 lateral mass, the thickness of the pedicle and the angle of attack of the screw in the isthmus of C2 to the horizontal. Results: The mean values were, respectively: right 23.08 mm and left 23.16 mm, right 6.46 mm and left 6.50 mm, right 44.50O and left 44.95O. Discussion: The leading screw’s manufacturers have implants compatible with the anatomical measurements found in this work. Considering the wide diffusion and mastery of Magerl’s technique in our country and around the world, this is a safe surgical option that provides mechanical stability. Conclusion: Magerl’s technique, according to tomographic analysis, can be used in patients with rheumatoid arthritis. Levels of Evidence IV,Case Series.

Humans , Male , Female , Arthritis, Rheumatoid/surgery , Bone Screws , Spine/anatomy & histology , Spine/physiopathology , Spinal Fusion/rehabilitation , Patient Safety , Data Interpretation, Statistical , Tomography, X-Ray Computed