Investigation of anulus fibrosus morphology in human fetus intervertebral discs.

OBJECTIVE: To determine whether the thickness of the anulus fibrosus (AF) structure of the intervertebral disc plays a role in disc herniation etiology, an important pathology. METHODS: We performed this study between February 2000 and May 2001 at Karadeniz Technical University Medical Faculty, Turkey. We used 20 human fetus cadavers with intrauterine ages between 22 and 41 weeks, taking into consideration the highest, lowest, and average frequencies, with 3 each of cervical, thoracal, and lumbar parts of the vertebral column, using a total of 9 intervertebral discs. We measured the thickness of the AF layer in each intervertebral disc in anterior, posterior, postero-dexter, and postero-sinister locations. We performed comparisons among the values obtained at the same level, and of comparative thicknesses at the same location at other levels. RESULTS: It was determined that there was no difference between the thickness of the AF in the same location at the various levels of intervertebral discs, but that at almost all levels, the thickness in posterior and anterior locations was significantly less compared to that in posterolateral locations. CONCLUSION: Anulus fibrosus thickness is not directly related to the incidence of disk hernia at different levels of the vertebral column according to the values obtained from this study.

Damage to coronary arteries during mitral valve surgery.

BACKGROUND: The rheumatic cardiac valve diseases are one of the most important heart problems in Turkey. In mitral valve surgery, the relationship between the anulus fibrosus sinister and the coronary arteries is extremely critical for the postoperative life of the patient. METHODS: The study was performed with human adult hearts. The aim of this study of 50 hearts was to understand the existing correlations between the mitral annulus and the coronary arteries. We determined the right or left dominance or codominance of the anulus fibrosus sinister on each heart and stu died the relationship of the mitral annulus to the circumflex coronary artery (CCA) and the left posterior descending coronary artery. RESULTS: The distances of the anulus fibrosus sinister from the CCA and interventricularis posterior arteries w e re measured with a flexible ruler. In 19 of 50 cases, the distance of the coronary artery from the annulus was 3 mm at 23 different points, 2 mm at 8 different points, and 1 mm at 2 different points. CONCLUSIONS: In mitral valve surgery, damage to the CCA can occur, especially in patients with left coronary dominance or codominance in which the CCA is running in the atrioventricular groove very close to the mitral annulus. Therefore, this study emphasizes the importance of knowing the coronary artery anatomy preoperatively.