Commented Glossary for Rheumatic Spinal Diseases, Based on Pathologyf
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Spinal Deformity Study Group
Spinal Deformity Study Group Editors in Chief Radiographic Michael F. O’Brien, MD Timothy R. Kuklo, MD Kathy M. Blanke, RN Measurement Lawrence G. Lenke, MD Manual B T2 T5 T2–T12 CSVL T5–T12 +X° -X +X° C7PL T12 L2 A S1 ©2008 Medtronic Sofamor Danek USA, Inc. – 0 + Radiographic Measurement Manual Editors in Chief Michael F. O’Brien, MD Timothy R. Kuklo, MD Kathy M. Blanke, RN Lawrence G. Lenke, MD Section Editors Keith H. Bridwell, MD Kathy M. Blanke, RN Christopher L. Hamill, MD William C. Horton, MD Timothy R. Kuklo, MD Hubert B. Labelle, MD Lawrence G. Lenke, MD Michael F. O’Brien, MD David W. Polly Jr, MD B. Stephens Richards III, MD Pierre Roussouly, MD James O. Sanders, MD ©2008 Medtronic Sofamor Danek USA, Inc. Acknowledgements Radiographic Measurement Manual The radiographic measurement manual has been developed to present standardized techniques for radiographic measurement. In addition, this manual will serve as a complimentary guide for the Spinal Deformity Study Group’s radiographic measurement software. Special thanks to the following members of the Spinal Deformity Study Group in the development of this manual. Sigurd Berven, MD Hubert B. Labelle, MD Randal Betz, MD Lawrence G. Lenke, MD Fabien D. Bitan, MD Thomas G. Lowe, MD John T. Braun, MD John P. Lubicky, MD Keith H. Bridwell, MD Steven M. Mardjetko, MD Courtney W. Brown, MD Richard E. McCarthy, MD Daniel H. Chopin, MD Andrew A. Merola, MD Edgar G. Dawson, MD Michael Neuwirth, MD Christopher DeWald, MD Peter O. Newton, MD Mohammad Diab, MD Michael F. -
Nervous System Lymphoma with Sciatic Nerve Involvement in Two Cats Diagnosed Using Computed Tomography and Ultrasound Guided Fine Needle Aspiration
VlaamsVlaams DiergeneeskundigDiergeneeskundig Tijdschrift,Tijdschrift, 2014,2014, 8383 Case report 107107 Nervous system lymphoma with sciatic nerve involvement in two cats diagnosed using computed tomography and ultrasound guided fine needle aspiration Diagnose van zenuwstelsellymfoom met aantasting van de nervus ischiadicus met behulp van computertomografie en echogeleide dunnenaaldaspiratie bij twee katten 1G. Gory, 1J. Couturier, 1E. Cauvin, 2C. Fournel – Fleury, 1L. Couturier, 1D.N. Rault 1 Azurvet, Referral Center in Veterinary Diagnostic Imaging and Neurology, Hippodrome, 2 Boulevard Kennedy 06800 Cagnes-sur-Mer, France 2 VetAgro-Sup – Campus Vétérinaire de Lyon, 1 Avenue Bourgelat 69280 Marcy L’Etoile, France [email protected] A BSTRACT Two cats were presented with a recent history of difficulty in walking and jumping. Neurolo- gical examination was consistent with a lumbosacral or a sciatic nerve lesion in both cases with an additional C6-T2 spinal cord segment lesion in case 2. Differential diagnosis included neo- plastic, inflammatory/infectious (neuritis, meningomyelitis, discospondylitis) and compressive disc disease. Computed tomography (CT) revealed an enlarged, contrast enhancing sciatic nerve from the L7-S1 intervertebral foramen, to the distal third portion of the femoral shaft. In case 2, CT also revealed an enlarged femoral nerve and an extradural mass causing mild compression of the spinal cord at T1-2 and T3-4. Ultrasonography allowed to perform fine needle aspiration of the affected sciatic nerve. Cytology was highly suggestive of indolent, small cell lymphoma in case 1, and confirmed a high-grade lymphoma in case 2, both belonging to the large granular lymphoma subtype. SAMENVATTING Twee katten werden aangeboden met een recente voorgeschiedenis van problemen met stappen en springen. -
Lumbar Spondylosis Page 1 of 3
Lumbar Spondylosis Page 1 of 3 Today News Reference Education Log In Register Lumbar Spondylosis • Author: Bruce M Rothschild, MD; Chief Editor: Allen R Wyler, MD more... Updated: Jan 23, 2013 Background Lumbar spondylosis, as shown in the image below, describes bony overgrowths (osteophytes), predominantly those at the anterior, lateral, and, less commonly, posterior aspects of the superior and inferior margins of vertebral centra (bodies). This dynamic process increases with, and is perhaps an inevitable concomitant, of age. Anteroposterior view of lumbar spine. Vertical overgrowths from margins of vertebral bodies represent osteophytes. Spondylosis deformans is responsible for the misconception that osteoarthritis was common in dinosaurs.[1] Osteoarthritis was rare, but spondylosis actually was common. Lumbar spondylosis usually produces no symptoms. When back or sciatic pains are symptoms, lumbar spondylosis is usually an unrelated finding. Past teleologically misleading names for this phenomenon are degenerative joint disease (it is not a joint), osteoarthritis (same critique), spondylitis (totally different disease), and hypertrophic arthritis (not an arthritis). For further reading, please see the Medscape Reference article Lumbar Spondylosis and Spondylolysis. http://emedicine.medscape.com/article/249036-overview 5/5/2014 Lumbar Spondylosis Page 2 of 3 Contributor Information and Disclosures Author Bruce M Rothschild, MD Professor of Medicine, Northeast Ohio Medical University; Adjunct Professor, Department of Biomedical Engineering, University of Akron; Research Associate, University of Kansas Museum of Natural History; Research Associate, Carnegie Museum Bruce M Rothschild, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Rheumatology, International Skeletal Society, New York Academy of Sciences, Sigma Xi, and Society of Skeletal Radiology Disclosure: Nothing to disclose. -
CERVICAL SPONDYLOSIS Pathogenesis the Canal Diameter Is
CERVICAL SPONDYLOSIS Pathogenesis The canal diameter is reduced by 1. Osteophytes, thickened ligamentum flavum, protruded disc 2. Hyperextension of the spine reduces the canal diameter by shingling effect of lamina and buckling of Ligamentum flavum 3. Retrolisthesis with extension 4. Hypermobility in the level above degenerated disc can cause myelopathy 5. Vascular compromise in spondylosis may cause myelopathy Disc is innervated by sinu‐vertebral nerve formed from ventral nerve root and sympathetic plexus. This nerve turns back at intervertebral foramen and supplies: annulus fibrosus, posterior longitudinal ligament, and periosteum of the vertebra Clinical A B C 1. Axial Pain patterns proved during discography at each level A Level between C2‐3 B “ C3‐4 C “ C4‐5 D “ C5‐6 E “ C6‐7 D E Look for trigger points. Pain is more on extending the neck. 2. Red flags: Night pain Persistent pain > 3months Any associated primary tumour Weight loss and sweat 3. Referred or radicular pain C6 to the thumb, C7 to the middle finger C8 to the little finger C6 nerve root exist between C5‐C6 vertebra. At cervical spine, both disc herneation and stenosis affect the exit root [In the lumbar region, transit root is involved in disc herniation] If more than one nerve root involvement: rule out myelopathy Sometimes, the pain can be referred to heart lungs and TMJ joint from Cervical spondylosis 4. Spurling’s manoeuvre: Extension and lateral rotation to the side of pain [refer clinical examination] Differential diagnosis for radiculopathy Peripheral entrapment syndrome Rotator cuff syndrome Brachial plexitis and herpes Spinal tumours Cardiac ischemia Investigations X rays AP, Lateral, Flexion‐extension lateral MRI is gold standard Myelopathy Types 1. -
Genetic Counselling Improves the Molecular Characterisation of Dementing Disorders
Journal of Personalized Medicine Review Genetic Counselling Improves the Molecular Characterisation of Dementing Disorders Stefania Zampatti 1, Michele Ragazzo 2, Cristina Peconi 1, Serena Luciano 1, Stefano Gambardella 3,4, Valerio Caputo 2 , Claudia Strafella 1 , Raffaella Cascella 1,5, Carlo Caltagirone 6 and Emiliano Giardina 1,2,* 1 Genomic Medicine Laboratory UILDM, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; [email protected] (S.Z.); [email protected] (C.P.); [email protected] (S.L.); [email protected] (C.S.); [email protected] (R.C.) 2 Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy; [email protected] (M.R.); [email protected] (V.C.) 3 IRCCS Neuromed, 86077 Pozzilli, Italy; [email protected] 4 Department of Biomolecular Sciences, University of Urbino “Carlo Bo”, 61029 Urbino, Italy 5 Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, 1000 Tirana, Albania 6 Department of Clinical and Behavioral Neurology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; [email protected] * Correspondence: [email protected] Abstract: Dementing disorders are a complex group of neurodegenerative diseases characterised by different, but often overlapping, pathological pathways. Genetics have been largely associated with the development or the risk to develop dementing diseases. Recent advances in molecular technologies permit analyzing of several genes in a small time, but the interpretation analysis is Citation: Zampatti, S.; Ragazzo, M.; complicated by several factors: the clinical complexity of neurodegenerative disorders, the frequency Peconi, C.; Luciano, S.; Gambardella, of co-morbidities, and the high phenotypic heterogeneity of genetic diseases. -
Acquired Degenerative Changes of the Intervertebral Segments at And
European Journal of Radiology 50 (2004) 134–158 Acquired degenerative changes of the intervertebral segments at and suprajacent to the lumbosacral junction A radioanatomic analysis of the nondiscal structures of the spinal column and perispinal soft tissues J. Randy Jinkins a,b,∗ a Department of Radiologic Sciences, Downstate Medical Center, State University of New York, Brooklyn, NY 11203, USA b Fonar Corporation, 110 Marcus Drive, Melville, NY 11747, USA Received 3 October 2003; received in revised form 9 October 2003; accepted 13 October 2003 Abstract A review of the imaging features of normal and degenerative anatomy of the spine on medical imaging studies shows features that have been largely overlooked or poorly understood by the imaging community in recent years. The imaging methods reviewed included computed tomography (CT) with multiplanar reconstructions and magnetic resonance imaging (MRI). A routine part of the MRI examination included fat-suppressed T2 weighted fast-spin- or turbo-spin-echo acquisitions. As compared to the normal features in asymptomatic volunteers, alterations in the observed CT/MRI morphology and MR signal characteristics were sought in symptomatic individuals. Findings in symptomatic subjects which departed from the normal anatomic features of the posterior spinal elements in asymptomatic volunteers included: rupture of the interspinous ligament(s), neoarthrosis of the interspinous space with perispinous cyst formation, posterior spinal facet (zygapophyseal joint) arthrosis, related central spinal canal, lateral recess (subarticular zone) and neural foramen stenosis, posterior element alterations associated with various forms of spondylolisthesis, and perispinal muscle rupture/degeneration. These findings indicate that the posterior elements are major locations of degenerative spinal and perispinal disease that may accompany or even precede degenerative disc disease. -
Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Spondylosis Deformans in Purebred Dogs: a Retrospective Radiographic Study Q ⇑ Hendrik-Jan C
The Veterinary Journal 190 (2011) e84–e90 Contents lists available at ScienceDirect The Veterinary Journal journal homepage: www.elsevier.com/locate/tvjl Diffuse idiopathic skeletal hyperostosis (DISH) and spondylosis deformans in purebred dogs: A retrospective radiographic study q ⇑ Hendrik-Jan C. Kranenburg a, , George Voorhout b, Guy C.M. Grinwis c, Herman A.W. Hazewinkel a, Björn P. Meij a a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands b Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands c Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands article info abstract Article history: A retrospective radiographic study was performed to investigate the prevalence of diffuse idiopathic skel- Accepted 6 April 2011 etal hyperostosis (DISH) and spondylosis deformans (spondylosis) in 2041 purebred dogs and to deter- mine association with age, gender and breed. Four cases of DISH provided information on the appearance of canine DISH. Keywords: The prevalence of DISH and spondylosis was 3.8% (78/2041) and 18.0% (367/2041), respectively. Of Diffuse idiopathic skeletal hyperostosis dogs with DISH, 67.9% (53/78) also had spondylosis, whereas 14.0% (53/367) of dogs with spondylosis DISH also had DISH. Dogs with DISH and/or spondylosis were significantly older than those without spinal Spondylosis exostosis. The prevalence of DISH and spondylosis was 40.6% (28/69) and 55.1% (38/69), respectively, Dogs Radiography in Boxer dogs. Nineteen smaller breeds were not affected by DISH, but showed signs of spondylosis; only standard Poodles appeared not to be affected by either disorder. -
Canine Thoracolumbar Intervertebral Disk Disease: Diagnosis, Prognosis, and Treatment*
3 CE CREDITS CE Article Canine Thoracolumbar Intervertebral Disk Disease: Diagnosis, Prognosis, and Treatment* ❯❯ John F. Griffin IV, DVM Abstract: Thoracolumbar intervertebral disk disease (IVDD) is a common, important cause of ❯❯ Jonathan M. Levine, DVM, paraspinal hyperesthesia, pelvic limb ataxia, paraparesis, paraplegia, and urinary and fecal in- DACVIM (Neurology) continence in dogs. A companion article reviewed pathophysiology, epidemiology, physical ex- ❯❯ Sharon C. Kerwin, DVM, amination, and emergency medical therapy. This article addresses the diagnosis, prognosis, and MS, DACVS treatment of dogs with thoracolumbar IVDD. ❯❯ Robert C. Cole, DVM, DACVR horacolumbar intervertebral disk better positioning and higher-quality radio- Texas A&M University College Station, Texas disease (IVDD) is a broad term, graphs but may not be necessary. Survey Tencompassing disk degeneration radiography can be conducted under anes- and clinical neurologic disease due to disk thesia immediately before myelography and herniation. Canine IVDD is the most com- can identify the primary site of disk hernia- mon cause of thoracolumbar myelopathy tion in 51% to 61% of cases; its ability to with paraspinal hyperesthesia.1,2 A thor- identify secondary sites of disk herniation ough understanding of diagnostic modali- is less reliable.2,6 Surgical outcome is poorer ties, prognosis, and treatment options is in dogs treated surgically on the basis of At a Glance crucial to medical decision making and survey radiography alone compared with comprehensive care. -
Pattern of Degenerative Lumbar Retrolisthesis in Basrah Thamer a Hamdan, Mubder a M
Pattern of Degenerative lumbar Retrolisthesis in Basrah Thamer A Hamdan, Mubder A M. Saeed & Yas k. Hadood Basrah Journal Original Article Of Surgery Bas J Surg, June, 21, 2015 PATTERN OF DEGENERATIVE LUMBAR RETROLISTHESIS IN BASRAH Thamer A Hamdan*, Mubder A Mohammed Saeed# & Yas khudair Hadood@ *FRCS, FRCP, FICS, FACS, American Board (Orth.), Professor of Orthopedic Surgery. #FICMS, (Orth.) Assistant Prof. of Orthopedic Surgery. College of Medicine, University of Basrah, Basrah, Iraq. @MB,ChB, Postgraduate Arab Board Medical Specialization (Orth.) Abstract Although retrolisthesis is not a well-known condition by many medical specialists dealing with back problems and it has been regarded as a radiological incidental finding with no clinical significance, a growing prove is now evolving stating that retrolisthesis could be a cause of many backache complaints and a sequelae of an altered spine biomechanics. Objectives: to study and analyze the various biomechanical characteristics of retrolisthesis and its relationship with various radiological parameters of the lumbar spine and other patient’s factors. Patients and Method: Forty patients, twenty six males, and fourteen females with an age range from 40–66 years with radiological evidence of significant lumbar spine retrolisthesis (slip > 3 millimeters) were evaluated clinically and radiologically by plain radiography and MRI in Basra General Hospital and Ibn AL-Bittar Private Hospital, during the period from the 1st of August 2014 to the 1st of March 2015. After a thorough history and physical examination, various radiological parameters were obtained including the lumbar lordosis, sacral slop, pelvic incidence, pelvic tilt, all those measurements were done digitally. A statistical analysis was made via IBM SPSS ver.17 and the results were compared with that of similar studies. -
A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation
Hindawi Case Reports in Orthopedics Volume 2021, Article ID 5514720, 4 pages https://doi.org/10.1155/2021/5514720 Case Report A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation Matthew T. Neal, Maziyar A. Kalani , and Mark K. Lyons Department of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA Correspondence should be addressed to Mark K. Lyons; [email protected] Received 5 January 2021; Revised 17 March 2021; Accepted 19 March 2021; Published 25 March 2021 Academic Editor: Taketoshi Yasuda Copyright © 2021 Matthew T. Neal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The anterior lumbar interbody fusion (ALIF) is a well-established procedure used to treat a multitude of spinal pathologies. When performed at the L5-S1 level, the ALIF is often supplemented with posterior pedicle screw and rod fixation. Because the interbody device can restore disk and foraminal height, one benefit of the ALIF procedure is indirect neural decompression in the spinal canal and neural foramina. If the contour of the posterior rod is not matched to the exact position of the tulip heads on the pedicle screws, spondylolisthesis can be introduced, leading to foraminal stenosis and nerve compression. This concern is particularly germane when the posterior instrumentation is placed percutaneously without any direct foraminal decompression. In this report, we describe a patient who had an L4-S1 ALIF, resulting in new L5-S1 retrolisthesis and worsening L5 radiculopathy. -
Feline Degenerative Joint Disease
Veterinary Surgery 39:2–13, 2010 INVITED REVIEW Feline Degenerative Joint Disease B. DUNCAN X. LASCELLES, BSc, BVSc, PhD, DSAS(ST), Diplomate ACVS & ECVS Objective: To critically review and collate published information on feline degenerative joint disease (DJD) and identify areas in which information is lacking. Study Design: Critical literature review. Methods: Literature search through Pub Med, Commonwealth Agricultural Bureau Abstracts published in the English Language, or translated into English (January 1940–August 2008). Results: Although there are no prospective studies, the prevalence of radiographic DJD appears to be high and can be associated with clinical signs of decreased mobility. There appears to be a mismatch between radiographic and clinical examination findings (pain response). There is little information on the cause of DJD in different joints. There are no fully validated subjective or objective assessment systems for the measurement of chronic DJD-associated pain in the cat. Development of a feline model of chronic DJD-associated pain may speed the development and evaluation of candidate pain-alleviating compounds and treatments. Conclusions: The high prevalence of feline DJD and lack of information about it, suggests further investigation is needed. Clinical Relevance: Feline DJD occurs with high frequency, and yet there is little to guide the clinician on prevention or treatment. r Copyright 2010 by The American College of Veterinary Surgeons INTRODUCTION the evidence for efficacy of postulated treatments for this pain. URPRISINGLY LITTLE is known about feline All mammals develop DJD, the progressive destruc- Sdegenerative joint disease (DJD) although there tion of one or more components of joints—cartilage, have been recent attempts to characterize feline joint dis- subchondral bone, ligaments, and joint capsule. -
Lumbar Degenerative Disease Part 1
International Journal of Molecular Sciences Article Lumbar Degenerative Disease Part 1: Anatomy and Pathophysiology of Intervertebral Discogenic Pain and Radiofrequency Ablation of Basivertebral and Sinuvertebral Nerve Treatment for Chronic Discogenic Back Pain: A Prospective Case Series and Review of Literature 1, , 1,2, 1 Hyeun Sung Kim y * , Pang Hung Wu y and Il-Tae Jang 1 Nanoori Gangnam Hospital, Seoul, Spine Surgery, Seoul 06048, Korea; [email protected] (P.H.W.); [email protected] (I.-T.J.) 2 National University Health Systems, Juronghealth Campus, Orthopaedic Surgery, Singapore 609606, Singapore * Correspondence: [email protected]; Tel.: +82-2-6003-9767; Fax.: +82-2-3445-9755 These authors contributed equally to this work. y Received: 31 January 2020; Accepted: 20 February 2020; Published: 21 February 2020 Abstract: Degenerative disc disease is a leading cause of chronic back pain in the aging population in the world. Sinuvertebral nerve and basivertebral nerve are postulated to be associated with the pain pathway as a result of neurotization. Our goal is to perform a prospective study using radiofrequency ablation on sinuvertebral nerve and basivertebral nerve; evaluating its short and long term effect on pain score, disability score and patients’ outcome. A review in literature is done on the pathoanatomy, pathophysiology and pain generation pathway in degenerative disc disease and chronic back pain. 30 patients with 38 levels of intervertebral disc presented with discogenic back pain with bulging degenerative intervertebral disc or spinal stenosis underwent Uniportal Full Endoscopic Radiofrequency Ablation application through either Transforaminal or Interlaminar Endoscopic Approaches. Their preoperative characteristics are recorded and prospective data was collected for Visualized Analogue Scale, Oswestry Disability Index and MacNab Criteria for pain were evaluated.