ABSTRACT
Dual-energy x-ray absorptiometry (DXA) is an established method for estimating bone mineral density (BMD) of the lumbar spine. In a prospective study, the sensitivity of BMD measurements between anteroposterior and lateral projections were evaluated in 204 postmenopausal women based on their DXA analysis. Patients were divided into two groups according to the absence or presence of lumbar scoliosis. Lateral projection DXA measurements were more sensitive than AP projection measurements for early detection of bone loss in postmenopausal women. Lateral projection DXA analysis is not recommended in spines with lumbar scoliosis.
Subject(s)
Absorptiometry, Photon/methods , Lumbar Vertebrae/physiology , Adult , Aged , Bone Density , Female , Humans , Male , Middle Aged , Prospective Studies , Scoliosis/physiopathology , Sensitivity and SpecificityABSTRACT
STUDY DESIGN: This was a prospective study of 35 consecutive patients in whom pedicle screw position was assessed after surgery, using lateral radiographs and computed tomography. OBJECTIVE: To evaluate the accuracy of plain radiographs and computed tomography in assessment of pedicle screw position. SUMMARY OF BACKGROUND DATA: Imaging techniques, such as postoperative anteroposterior and lateral plain radiographs and computed tomography, are currently the primary means of assessing pedicle screw placement. METHODS: Postoperative radiographs and computed tomographic scans were used to evaluate the position of 220 pedicle screws inserted in the spines of 35 consecutive patients who underwent thoracic and lumbar spine fusion and instrumentation. No recognized neurologic complication resulted from pedicle screw placement. Screw position was graded as in, out, or questionable. All observations were performed independently by three observers. The authors also analyzed the position of the screws according to the underlying spinal disease. RESULTS: More misplaced screws were clearly seen on computed tomographic scans than on plain radiographs; however, this difference was not statistically significant. Interobserver differences were not statistically significant. Intraobserver differences approached statistical significance when the results of the two test were compared. CONCLUSIONS: Although the accuracy of computed tomographic imaging is better than that of plain radiographs, the difference does not reach statistical significance. Postoperative use of plain radiographs remains a reliable method for evaluation of pedicle screw insertion in the absence of neurologic deficit.
Subject(s)
Bone Screws , Lumbar Vertebrae/diagnostic imaging , Spinal Diseases/diagnostic imaging , Spinal Fusion/instrumentation , Thoracic Vertebrae/diagnostic imaging , Evaluation Studies as Topic , Female , Humans , Internal Fixators , Lumbar Vertebrae/surgery , Male , Observer Variation , Prospective Studies , Spinal Diseases/surgery , Thoracic Vertebrae/surgery , Tomography, X-Ray ComputedSubject(s)
Cervical Vertebrae/injuries , Joint Dislocations/diagnostic imaging , Spinal Fractures/diagnostic imaging , Thoracic Vertebrae/injuries , Adult , Humans , Joint Dislocations/complications , Joint Dislocations/surgery , Male , Radiography , Spinal Cord Injuries/etiology , Spinal Fractures/complications , Spinal Fractures/surgeryABSTRACT
Hydatid disease is a rare parasitic disease that seldom involves the skeleton. Treatment is difficult because of problems with the preoperative diagnosis, the invasive nature of the bony involvement and the variable anaphylactic reaction to the cyst fluid antigen. We present 8 cases with osseous hydatidosis who were treated over a period of 11 years. The spine was involved in 2 cases, the ilium in 2, the hip in 2, the tibia in 1 and the humerus in 1. We point out that diagnosis is difficult and the prognosis is often poor.
