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Spinal anatomy

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https://www.readbyqxmd.com/read/29033731/ultrasound-guided-continuous-spinal-anesthesia-for-cesarean-section-in-a-parturient-with-scoliosis-corrected-with-harrington-s-rod-surgery
#1
Amer Majeed, Iftikhar Ahmed, Ghadah Jamaan Alkahtani, Nasser Abdullah Altahtam
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29032887/virtual-simulation-in-enhancing-procedural-training-for-fluoroscopy-guided-lumbar-puncture-a-pilot-study
#2
Saad Ali, Monther Qandeel, Rishi Ramakrishna, Carina W Yang
RATIONALE AND OBJECTIVES: Fluoroscopy-guided lumbar puncture (FGLP) is a basic procedural component of radiology residency and neuroradiology fellowship training. Performance of the procedure with limited experience is associated with increased patient discomfort as well as increased radiation dose, puncture attempts, and complication rate. Simulation in health care is a developing field that has potential for enhancing procedural training. We demonstrate the design and utility of a virtual reality simulator for performing FGLP...
October 9, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29024413/deep-tissue-loads-in-the-seated-buttocks-on-an-off-loading-wheelchair-cushion-versus-air-cell-based-and-foam-cushions-finite-element-studies
#3
Lea Peko Cohen, Amit Gefen
For wheelchair users, a common injury is a sitting-acquired pressure ulcer (PU) which typically onsets near the interface between the ischial tuberosity (IT) and the overlying soft tissues. The risk of developing PUs can be reduced considerably if an adequate cushion is placed on the wheelchair in order to protect tissues from PUs by minimising interface mechanical loads between the body and cushion and also, exposure to internal soft tissue loads. In this work, we studied the biomechanical performances of an off-loading (OL) cushion with limited adjustability, in comparison to a standard foam cushion and a fully adjustable air-cell-based (ACB) cushion...
September 6, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29018606/exceptional-soft-tissues-preservation-in-a-mummified-frog-eating-eocene-salamander
#4
Jérémy Tissier, Jean-Claude Rage, Michel Laurin
Fossils are almost always represented by hard tissues but we present here the exceptional case of a three-dimensionally preserved specimen that was 'mummified' (likely between 40 and 34 million years ago) in a terrestrial karstic environment. This fossil is the incomplete body of a salamander, Phosphotriton sigei, whose skeleton and external morphology are well preserved, as revealed by phase-contrast synchrotron X-ray microtomography. In addition, internal structures composed of soft tissues preserved in three dimensions are now identified: a lung, the spinal cord, a lumbosacral plexus, the digestive tract, muscles and urogenital organs that may be cloacal glands...
2017: PeerJ
https://www.readbyqxmd.com/read/29016507/cadaveric-nerve-and-artery-proximity-to-sacrospinous-ligament-fixation-sutures-placed-by-a-suture-capturing-device
#5
Aaron Z Katrikh, Rajuno Ettarh, Margie A Kahn
OBJECTIVE: To simulate sacrospinous ligament fixation on cadaveric specimens, describe the surrounding retroperitoneal anatomy, and estimate the risk to nerves and arteries for the purposes of optimizing safe suture placement. METHODS: Sacrospinous ligament fixation was performed on eight fresh-tissue female cadavers using a Capio ligature capture device. Distances from placed sutures to the following structures were measured: ischial spine; fourth sacral root; pudendal nerve; the nerve to coccygeus muscle; the nerve to levator ani muscle; inferior gluteal artery; and internal pudendal artery...
October 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28989844/use-of-intraoperative-ultrasound-during-spinal-surgery
#6
Viren S Vasudeva, Muhammad Abd-El-Barr, Yuri A Pompeu, Aditya Karhade, Michael W Groff, Yi Lu
STUDY DESIGN: Review and technical report. OBJECTIVE: Intraoperative ultrasound has been used by spine surgeons since the early 1980s. Since that time, more advanced modes of intraoperative imaging and navigation have become widely available. Although the use of ultrasound during spine surgery has fallen out of favor, it remains the only true real-time imaging modality that allows surgeons to visualize soft tissue anatomy instantly and continuously while operating...
October 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28987187/spinal-cord
#7
Umberto de Girolami, Tejus A Bale
We first present a brief historic review of developments in the understanding of spinal cord clinical neuroanatomy and neurophysiology over the past 200 years. We then discuss the technical aspects that apply to the examination of the human spinal cord giving details on the interrelations between the spinal cord and the overlying structures, including the meninges and vertebrae. The subsequent discussion focuses on diseases of the spinal cord. Diseases that affect the spinal cord are vascular disease, diseases of spinal column, trauma, developmental abnormalities, central nervous system degenerative disease, inflammatory disease, metabolic and nutritional myelopathies, and tumors...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28977457/the-frozen-elephant-trunk-technique-for-the-treatment-of-acute-complicated-type-b-aortic-dissection
#8
Maximilian Kreibich, Tim Berger, Julia Morlock, Stoyan Kondov, Johannes Scheumann, Fabian A Kari, Bartosz Rylski, Matthias Siepe, Friedhelm Beyersdorf, Martin Czerny
OBJECTIVES: Our goal was to report our preliminary results in patients with acute complicated Type B aortic dissection without a suitable landing zone for primary thoracic endovascular aortic repair who were treated with the frozen elephant trunk (FET) technique. METHODS: Within a 25-month period, 14 patients with acute complicated Type B aortic dissection underwent surgical repair using the FET technique. The reasons to perform the FET procedure were an ectatic ascending aorta/arch in 6 patients and the lack of an adequate landing zone in 8 patients...
August 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28972696/arterial-blood-supply-to-the-spinal-cord-in-animal-models-of-spinal-cord-injury-a-review
#9
REVIEW
David Mazensky, Slavka Flesarova, Igor Sulla
Animal models are used to examine the results of experimental spinal cord injury. Alterations in spinal cord blood supply caused by complex spinal cord injuries contribute significantly to the diversity and severity of the spinal cord damage, particularly ischemic changes. However, the literature has not completely clarified our knowledge of anatomy of the complex three-dimensional arterial system of the spinal cord in experimental animals, which can impede the translation of experimental results to human clinical applications...
October 3, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28966305/functional-vascular-anatomy-of-the-brain
#10
Michihiro Tanaka
Functional vascular anatomy is the study of anatomy in its relation to the function that figures out the normal and pathological vascularization of the brain and spinal cord. The mechanism of anatomical variations (e.g. fenestration of the basilar artery, persistent primitive trigeminal artery, and aberrant subclavian artery) can be explained according to the embryological development of the cardiovascular system. The most developmental process is common among the species of the vertebrates from the fish to the mammalian in the early phase of embryo...
October 2, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28964461/myelography-from-lipid-based-to-gadolinium-based-contrast-agents
#11
REVIEW
Donald B Price, A Orlando Ortiz
Myelographic contrast media of various types have been used over the past 100 years. Many of the early contrast agents had significant toxicities. Gas myelography was tried, but the contrast between gas and soft tissue is poor. Pantopaque, an oil-based iodinated medium was successfully used for decades, but was not compatible with computed tomography (CT) scanning because it was viscous, insoluble, and caused streak artifact. The development of water-soluble agents allowed even distribution in the subarachnoid space and excellent depiction of spinal anatomy on post-myelographic CT scanning...
November 2017: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/28960477/real-time-ultrasound-assessment-of-astronaut-spinal-anatomy-and-disorders-on-the-international-space-station
#12
Kathleen M Garcia, Michael F Harrison, Ashot E Sargsyan, Douglas Ebert, Scott A Dulchavsky
OBJECTIVES: Back pain is one of the most common conditions of astronauts during spaceflight and is hypothesized to be attributed to pathologic anatomic changes. Ultrasound (US) represents the only available imaging modality on the International Space Station, but a formal US protocol for imaging the structures of the spinal column does not exist. This investigation developed a method of acquiring diagnostic-quality images of the anterior lumbar and cervical regions of the spine during long-duration spaceflight...
September 29, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28958025/spinal-ischaemia-after-thoracic-endovascular-aortic-repair-with-left-subclavian-artery-sacrifice-is-there-a-critical-stent-graft-length
#13
Fabian A Kari, Babak Saravi, Sonja Krause, Luisa Puttfarcken, Karin Wittmann, Katharina Förster, Bartosz Rylski, Sven Maier, Ulrich Göbel, Matthias Siepe, Martin Czerny, Friedhelm Beyersdorf
OBJECTIVES: Thoracic endovascular aortic repair (TEVAR) is used for treatment of thoracic aortic pathologies, but the covered stent graft can induce spinal ischaemia depending on the length used. The left subclavian artery contributes to spinal cord collateralization and is frequently occluded by the stent graft. Our objective was to investigate the impact of covered stent graft length on the risk of spinal ischaemia in the setting of left subclavian artery sacrifice. METHODS: Twenty-six pigs (German country race, mean body weight 36 ± 4 kg) underwent simulated descending aortic TEVAR via left lateral thoracotomy, with left subclavian artery and thoracic segmental artery occlusion in normothermia...
August 24, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28952339/altered-brainstem-anatomy-in-migraine
#14
Kasia K Marciszewski, Noemi Meylakh, Flavia Di Pietro, Vaughan G Macefield, Paul M Macey, Luke A Henderson
Background The exact mechanisms responsible for migraine remain unknown, although it has been proposed that changes in brainstem anatomy and function, even between attacks, may contribute to the initiation and maintenance of headache during migraine attacks. The aim of this investigation is to use brainstem-specific analyses of anatomical and diffusion weighted images to determine if the trigeminal system displays altered structure in individuals with migraine. Methods Voxel-based morphometry of T1-weighted anatomical images (57 controls, 24 migraineurs) and diffusion tensor images (22 controls, 24 migraineurs) were used to assess brainstem anatomy in individuals with migraine compared with controls...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28951393/arteriovenous-fistulae-of-the-filum-terminale
#15
REVIEW
Enrico Giordan, Waleed Brinjikji, Elisa Ciceri, Giuseppe Lanzino
Filum terminale arteriovenous fistulae are a rare type of arteriovenous shunt generally characterized by a single direct communication between the artery of the filum terminale and a single draining vein. These intradural arteriovenous shunts are three times more common in men than women (mean age 55 years). Symptoms are related to venous congestion, vascular hypertension, and a putative chronic steal phenomenon which result in spinal cord ischemia and myelopathy. Interestingly, hemorrhage has never been reported as a mode of presentation...
September 26, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28937469/outcome-of-a-resident-spine-surgical-skills-training-program
#16
Brian P Calio, Christopher K Kepler, John D Koerner, Jeffrey A Rihn, Paul Millhouse, Kris E Radcliff
STUDY DESIGN: Cadaver training lab. OBJECTIVE: To determine if a technical cadaver skills training lab for spinal surgery increases resident confidence, satisfaction in training, and perception of operating room safety. SUMMARY OF BACKGROUND DATA: Resident training is an important topic in the setting of work hour reform. The use of supplemental materials such as videos, sawbones, and simulators may become important to adequately train orthopedic residents...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28936912/epidural-hematoma-development-contralateral-to-dura-after-lumbar-transforaminal-epidural-steroid-injection
#17
Semih Gungor, Rohit Aiyer
AIM: To illustrate the anatomical and pathophysiological risks of epidural hematoma formation, other than direct needle trauma, after lumbar transforaminal epidural steroid injection in the setting of severe central canal stenosis. CASE REPORT: This case report presents the development of an epidural hematoma after lumbar transforaminal epidural steroid injection in a patient who has anatomical risk factor of severe lumbar spinal stenosis. The anatomic location of epidural hematoma was at the injected level, but on the contralateral side of the dura at a distance from the needle path...
September 2017: Pain Management
https://www.readbyqxmd.com/read/28921843/potential-proton-and-photon-dose-degradation-in-advanced-head-and-neck-cancer-patients-by-intratherapy-changes
#18
Kristin Stützer, Annika Jakobi, Anna Bandurska-Luque, Steffen Barczyk, Carolin Arnsmeyer, Steffen Löck, Christian Richter
PURPOSE: Evaluation of dose degradation by anatomic changes for head-and-neck cancer (HNC) intensity-modulated proton therapy (IMPT) relative to intensity-modulated photon therapy (IMRT) and identification of potential indicators for IMPT treatment plan adaptation. METHODS: For 31 advanced HNC datasets, IMPT and IMRT plans were recalculated on a computed tomography scan (CT) taken after about 4 weeks of therapy. Dose parameter changes were determined for the organs at risk (OARs) spinal cord, brain stem, parotid glands, brachial plexus, and mandible, for the clinical target volume (CTV) and the healthy tissue outside planning target volume (PTV)...
September 18, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28921013/spinal-cord-injury-as-a-complication-of-thoracic-endovascular-aneurysm-repair
#19
REVIEW
Taijiro Sueda, Shinya Takahashi
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication of thoracic aortic aneurysm repair in the era of thoracic endovascular aneurysm repair (TEVAR). This review aims to clarify the causes of SCI during TEVAR and to propose ways that it may be prevented. METHODS AND RESULTS: We performed an extensive literature search of SCI during TEVAR. Based on the existing literature, we examined the anatomy of the anterior spinal cord artery, which supplies blood to the anterior aspect of the spinal cord, and discuss reported effective ways to prevent SCI during TEVAR, including augmentation of arterial blood pressure and drainage of cerebrospinal fluid...
September 18, 2017: Surgery Today
https://www.readbyqxmd.com/read/28912022/when-does-intraoperative-3d-imaging-play-a-role-in-transpedicular-c2-screw-placement
#20
Cornelius Jacobs, Philip P Roessler, Sebastian Scheidt, Milena M Plöger, Collin Jacobs, Alexander C Disch, Klaus D Schaser, Tony Hartwig
INTRODUCTION: The stabilization of an atlantoaxial (C1-C2) instability is demanding due to a complex atlantoaxial anatomy with proximity to the spinal cord, a variable run of the vertebral artery (VA) and narrow C2 pedicles. We perfomed the Goel & Harms fusion in combination with an intraoperative 3D imaging to ensure correct screw placement in the C2 pedicle. We hypothesized, that narrow C2 pedicles lead to a higher malposition rate of screws by perforation of the pedicle wall. The purpose of this study was to describe a certain pedicle size, under which the perforation rate rises...
September 8, 2017: Injury
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