Automatic measurement of vertebral rotation in idiopathic scoliosis

Study Design. Development of an automatic measurement algorithm and comparison with manual measurement methods. Objectives. To develop a new computer-based method for automatic measurement of vertebral rotation in idiopathic scoliosis from computed tomography images and to compare the automatic method with two manual measurement techniques. Summary of Background Data. Techniques have been developed for vertebral rotation measurement in idiopathic scoliosis using plain radiographs, computed tomography, or magnetic resonance images. All of these techniques require manual selection of landmark points and are therefore subject to interobserver and intraobserver error. Methods. We developed a new method for automatic measurement of vertebral rotation in idiopathic scoliosis using a symmetry ratio algorithm. The automatic method provided values comparable with Aaro and Ho's manual measurement methods for a set of 19 transverse computed tomography slices through apical vertebrae, and with Aaro's method for a set of 204 reformatted computed tomography images through vertebral endplates. Results. Confidence intervals (95%) for intraobserver and interobserver variability using manual methods were in the range 5.5 to 7.2. The mean (+/- SD) difference between automatic and manual rotation measurements for the 19 apical images was -0.5 degrees +/- 3.3 degrees for Aaro's method and 0.7 degrees +/- 3.4 degrees for Ho's method. The mean (+/- SD) difference between automatic and manual rotation measurements for the 204 endplate images was 0.25 degrees +/- 3.8 degrees. Conclusions. The symmetry ratio algorithm allows automatic measurement of vertebral rotation in idiopathic scoliosis without intraobserver or interobserver error due to landmark point selection.

Cirurgia de fraturas ósseas na osteoporose: Fraturas da coluna vertebral

As fraturas que ocorrem no osso osteoporótico são por definição estrita fraturas patológicas. Podem estar relacionadas com quedas da própria altura ou de traumatismos de baixa energia cinética e envolvem habitualmente a anca, o punho, a coluna vertebral e o ombro. As fraturas osteoporóticas a que se associa a sarcopenia, representam um sério problema de saúde pública em todo o mundo, com uma proporção epidémica e um impacto devastador na morbilidade e mortalidade dos pacientes, assim como nos custos socioeconómicos. Apesar dos avanços registados na prevenção e no tratamento farmacológico da osteoporose bem como no tratamento cirúrgico das fraturas ósseas, continuam a ser desenvolvidos novos biomateriais metálicos e substitutos sintéticos do osso com a intenção de se conseguir alcançar melhores resultados clínicos. Dentro deste contexto incluem-se os cimentos hidráulicos, os parafusos expansivos, os parafusos dinâmicos, as malhas metálicas de titânio, as placas bloqueadas, entre outros, em conjugação com técnicas minimamente invasivas e com diferentes estratégias cirúrgicas. O objetivo central deste trabalho assenta nas modalidades cirúrgicas mais usadas para o tratamento das fraturas em osso osteoporótico, com especial destaque para as fraturas da coluna vertebral.

Oculo-auriculo-vertebral spectrum: a review of the literature and genetic update

Oculo-auriculo-vertebral spectrum (OAVS, OMIM 164 210) is a developmental disorder primarily involving structures derived from the first and second pharyngeal arches during embryogenesis. The phenotype is clinically heterogeneous and is typically characterised by abnormal development of the ear, mandible anomalies and defects of the vertebral column. OAVS may occur as a multiple congenital abnormality, and associated findings include anomalies of the eye, brain, heart, kidneys and other organs and systems. Both genetic and environmental factors are thought to contribute to this craniofacial condition, however, the mechanisms are still poorly understood. Here, we present a review of the literature on OAVS, discussing what is known about the aetiology, candidate loci, possible mechanisms and the range of clinical features that characterise this condition. We also comment on some important aspects of recurrence risk counselling to aid clinical management.

Cirurgia de fraturas ósseas na osteoporose: Fraturas da coluna vertebral

As fraturas que ocorrem no osso osteoporótico são por definição estrita fraturas patológicas. Podem estar relacionadas com quedas da própria altura ou de traumatismos de baixa energia cinética e envolvem habitualmente a anca, o punho, a coluna vertebral e o ombro. As fraturas osteoporóticas a que se associa a sarcopenia, representam um sério problema de saúde pública em todo o mundo, com uma proporção epidémica e um impacto devastador na morbilidade e mortalidade dos pacientes, assim como nos custos socioeconómicos. Apesar dos avanços registados na prevenção e no tratamento farmacológico da osteoporose bem como no tratamento cirúrgico das fraturas ósseas, continuam a ser desenvolvidos novos biomateriais metálicos e substitutos sintéticos do osso com a intenção de se conseguir alcançar melhores resultados clínicos. Dentro deste contexto incluem-se os cimentos hidráulicos, os parafusos expansivos, os parafusos dinâmicos, as malhas metálicas de titânio, as placas bloqueadas, entre outros, em conjugação com técnicas minimamente invasivas e com diferentes estratégias cirúrgicas. O objetivo central deste trabalho assenta nas modalidades cirúrgicas mais usadas para o tratamento das fraturas em osso osteoporótico, com especial destaque para as fraturas da coluna vertebral.

La terapia ocupacional como área de apoyo para evitar o controlar la depresión a consecuencia de problemas de columna: cervicalgia y lumbalgia, en pacientes del sexo femenino entre las edades de 20 a 55 años que asisten al Centro de Rehabilitación Integral de Oriente en el período de septiembre a noviembre de 2007

El presente estudio, se realizó con el objetivo de: investigar el impacto de la terapia ocupacional como área de apoyo en el manejo emocional específicamente depresión en pacientes con problemas de cervicalgia y lumbalgia del sexo femenino entre las edades de 20 a 55 años que asisten al Centro de Rehabilitación Integral de Oriente, en el periodo comprendido de septiembre a noviembre de 2007. Es muy importante especificar el hecho de que el aspecto emocional no ha sido tomado en cuenta en la rehabilitación integral del usuario que adolece de cervicalgia y lumbalgia y es aquí donde radica el porque y para que la realización de la investigación; también, los beneficios que este traerá como son: Mejor condición física y estabilidad emocional para el paciente lo que contribuirá al mejor desenvolvimiento de sus roles en la sociedad.

CIL 6.1300 – Fragment of a dedication (perhaps a copy?) from the base of a ‘columna rostrata’ honoring Gaius Duilius, hero of the First Punic War

Photographs

Embolisation of Vertebral Artery Damaged Following Cervical Disc Removal

Introduction: The incidence of vertebral artery (VA) injury during cervical spine surgery is rare. Even though tamponade is effective in many cases, early consultation of an endovascular team is recommended if bleeding cannot be controlled. We report a case of emergent endovascular embolisation of left VA due to iatrogenic injury during anterior cervical disc removal and fusion. Case: A 47-year-old woman was admitted to our emergency department with serious arterial bleeding from the neck only hours after undergoing anterior cervical disc removal and fusion surgery. She was intubated and mechanically ventilated, however hemorrhage could not be successfully controlled by packing with surgical hemostatic agents. Cranial computed tomography, computed tomography of the cervical spine and CT angiography confirmed the suspected diagnosis of injury to the VA. Emergent endovascular embolisation successfully stopped the bleeding. Occlusion of the vessel was achieved by vascular plugging. The patient was discharged from our hospital 14 days after the intervention, receiving a revision surgery of the cervical spine on the day of embolisation. At the date of discharge she presented without any focal neurological deficit. Conclusion: Pre-operative radiographic imaging of the cervical spine should be used routinely to identify anatomic abnormalities of the vertebral arteries. Endovascular embolisation appears to be effective in treating acute iatrogenic dissection of the vertebral arteries.

Factors associated with an increased risk of vertebral fracture in monoclonal gammopathies of undetermined significance

International audience

Bioadsorción de Pb2+ en una columna empacada con biomasa inmovilizada

Se realizó la bioadsorciónde Pb2+ a escala laboratorio utilizando una columna empacada con biomasa de alga Chlorella sp. inmovilizada en pellets de alginato de calcio, variando el tamaño de partícula, el pH, y la concentraciónde Pb2+.

Age and growth of the bigeye thresher shark, Alopias superciliosus, from the pelagic longline fisheries in the tropical northeastern Atlantic Ocean, determined by vertebral band counts

The bigeye thresher, Alopias supercilious, is commonly caught as bycatch in pelagic longline fisheries targeting swordfish. Little information is yet available on the biology of this species, however. As part of an ongoing study, observers sent aboard fishing vessels have been collecting set of information that includes samples of vertebrae, with the aim of investigating age and growth of A. supercilious. A total of 117 specimens were sampled between September 2008 and October 2009 in the tropical northeastern Atlantic, with specimens ranging from 101 to 242 cm fork length (FL) (176 to 407 cm total length). The A. supercilious vertebrae were generally difficult to read, mainly because they were poorly calcified, which is typical of Lamniformes sharks. Preliminary trials were carried out to determine the most efficient band enhancement technique for this species, in which crystal violet section staining was found to be the best methodology. Estimated ages in this sample ranged from 2 to 22 years for females and 1 to 17 years for males. A version of the von Bertalanffy growth model (VBGF) re-parameterised to estimate L(0), and a modified VBGF using a fixed L(0) were fitted to the data. The Akaike information criterion (AIC) was used to compare these models. The VBGF produced the best results, with the following parameters: L(inf) = 293 cm FL, k = 0.06 y(-1) and L(0) = 111 cm FL for females; L(inf) = 206 cm FL, k = 0.18 y(-1) and L(0) = 93 cm FL for males. The estimated growth coefficients confirm that A. supercilious is a slow-growing species, highlighting its vulnerability to fishing pressure. It is therefore urgent to carry out more biological research to inform fishery managers more adequately and address conservation issues.

Age and growth of the smooth hammerhead shark, Sphyrna zygaena, in the Eastern Equatorial Atlantic Ocean, using vertebral sections

The smooth hammerhead shark Sphyrna zygaena (Sphyrnidae) is regularly caught as bycatch in pelagic longline fisheries, but is one of the least studied of all pelagic sharks. Recently, ICCAT (International Commission for the Conservation of Atlantic Tunas) issued recommendations underlining the need for more studies on the life history parameters of this and other pelagic shark species. To this end, the age and growth of S. zygaena were studied in the Eastern Equatorial Atlantic Ocean, in an area where growth parameters were not yet available for this species. Data from 139 specimens, caught between June and September 2009, ranging in size from 136 to 233 cm fork length (FL), were analysed. Preliminary trials were carried out to assess the most efficient growth band enhancement technique. These indicated that sectioning the vertebrae into 500 μm sections followed by staining with crystal violet produced the best results. Growth models were fitted using the traditional von Bertalanffy growth equation and a modification of this equation using a known size at birth. Growth models were compared using the Akaike information criterion (AIC). The von Bertalanffy growth equation seemed to be the most adequate model to describe growth in this species, with resulting growth parameters of L inf = 272 cm FL, k = 0.06 year for males and L inf = 285 cm FL, k = 0.07 year for females. In the first four years of life, S. zygaena grows 25 cm per year on average, but its growth slows down in later life. Future stock assessment models should incorporate these age and growth parameters for species management and conservation.

Congenital thoracic vertebral malformations in brachycephalic “screw-tailed” dog breeds: Validation of a human classification scheme and a method of Cobb angle measurement in the assessment of vertebral column deformity

Congenital vertebral malformations are common in brachycephalic “screw-tailed” dog breeds such as French bulldogs, English bulldogs, Boston terriers, and Pugs. Those vertebral malformations disrupt the normal vertebral column anatomy and biomechanics, potentially leading to deformity of the vertebral column and subsequent neurological dysfunction. The initial aim of this work was to study and determine whether the congenital vertebral malformations identified in those breeds could be translated in a radiographic classification scheme used in humans to give an improved classification, with clear and well-defined terminology, with the expectation that this would facilitate future study and clinical management in the veterinary field. Therefore, two observers who were blinded to the neurologic status of the dogs classified each vertebral malformation based on the human classification scheme of McMaster and were able to translate them successfully into a new classification scheme for veterinary use. The following aim was to assess the nature and the impact of vertebral column deformity engendered by those congenital vertebral malformations in the target breeds. As no gold standard exists in veterinary medicine for the calculation of the degree of deformity, it was elected to adapt the human equivalent, termed the Cobb angle, as a potential standard reference tool for use in veterinary practice. For the validation of the Cobb angle measurement method, a computerised semi-automatic technique was used and assessed by multiple independent observers. They observed not only that Kyphosis was the most common vertebral column deformity but also that patients with such deformity were found to be more likely to suffer from neurological deficits, more especially if their Cobb angle was above 35 degrees.