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Turkish Neurosurgery 2021To find out the anatomical changes in spine and pelvis, and the impact of various breast sizes of women on the quality of life.
AIM
To find out the anatomical changes in spine and pelvis, and the impact of various breast sizes of women on the quality of life.
MATERIAL AND METHODS
Sixty women with back pain volunteered to participate in this study. Their body mass index (BMI) was calculated. Clinical evaluation of the pain was assessed using the Oswestry Disability Index and visual analogue scale. Breast volumes were measured using the Grossman Rounder device. Scoliosis radiograms were obtained, and the cervical lordosis, thoracic kyphosis, lumbar lordosis, sacral slope, pelvic incidence and pelvic tilt angles were measured in patients. The relationship between the increasing breast size and BMI was investigated through all these parameters.
RESULTS
Increase in breast size positively changes the sagittal balance (r=0.356, p=0.005) and increases cervical lordosis (r=0.300, p=0.020). Increase in BMI leads to a positive sagittal balance (r=0.329, p=0.010) and increases the pelvic tilt (r=0.460, p=0.000). In patients with a positive sagittal balance, the sacral slope (r=-0.350, p=0.006) and the lumbar lordosis angle decrease (r=-0.552, p=0.000), whereas the pelvic tilt increases (r=0.298, p=0.021).
CONCLUSION
Macromastia has an impact on cervical lordosis and sagittal balance, while indirectly impacting the pelvic tilt rather than the thoracic kyphosis and lumbar lordosis.
Topics: Female; Humans; Kyphosis; Lordosis; Lumbar Vertebrae; Pelvis; Quality of Life; Sacrum; Scoliosis
PubMed: 33978220
DOI: 10.5137/1019-5149.JTN.30936-20.2 -
Journal of Rehabilitation Medicine Nov 2018To evaluate the relationships among spino-pelvic parameters, trunk balance and functional disability in patients with degenerative lumbar spondylolisthesis.
OBJECTIVE
To evaluate the relationships among spino-pelvic parameters, trunk balance and functional disability in patients with degenerative lumbar spondylolisthesis.
DESIGN
Cross-sectional study.
SUBJECTS
Forty-five patients with degenerative lumbar spondylolisthesis and 32 patients without degenerative lumbar spondylolisthesis.
METHODS
Spino-pelvic parameters (pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis) and pain severity were evaluated. Biodex balance tests (postural stability, limits of stability, modified clinical test of sensory interaction and balance, fall risk) and Quebec Back Pain Disability Scale (QBDS) scores were measured.
RESULTS
Intergroup differences were found in age, low back pain, limits of stability, pelvic incidence, pelvic tilt and some subscales of QBDS. Correlations were found: (i) in the degenerative lumbar spondylolisthesis group: between pelvic incidence and sacral slope/pelvic tilt/lumbar lordosis/height/limits of stability; sacral slope and lumbar lordosis/height/limits of stability/modified clinical test of sensory interaction and balance (eyes closed on foam); lumbar lordosis and body mass index/QBDS/postural stability/modified clinical test of sensory interaction and balance (eyes open and eyes closed on foam); (ii) in the non-degenerative lumbar spondylolisthesis group: between pelvic incidence and pelvic tilt; pelvic tilt and sacral slope/lumbar lordosis; sacral slope and lumbar lordosis/fall risk. All spino-pelvic parameters in the degenerative lumbar spondylolisthesis group and pelvic tilt in the non-degenerative lumbar spondylolisthesis group correlated with QBDS.
CONCLUSION
Pelvic tilt was the major compensating factor in both groups (patients with and without degenerative lumbar spondylolisthesis). Sacral slope and lumbar lordosis contributed to partial compensation in the degenerative lumbar spondylolisthesis group. Lumbar lordosis correlated with body mass index. Sacral slope could be an indicator of fall risk in the non-degenerative lumbar spondylolisthesis group.
Topics: Aged; Aged, 80 and over; Cross-Sectional Studies; Disability Evaluation; Female; Humans; Male; Middle Aged; Pelvis; Prospective Studies; Spine; Spondylolisthesis
PubMed: 30307025
DOI: 10.2340/16501977-2489 -
Taiwanese Journal of Obstetrics &... Nov 2022We report a case of an ovarian solitary fibrous tumor (SFT), which rarely occurs in the female genital system.
OBJECTIVE
We report a case of an ovarian solitary fibrous tumor (SFT), which rarely occurs in the female genital system.
CASE REPORT
A 63-year-old postmenopausal woman resorted to the tertiary center seeking management for an intra-abdominal mass. Physical examination disclosed a local abdominal distention. Ultrasound revealed an 18-cm complex mass with inner neovascularization. A whole abdominal computed scan (CT) demonstrated an 18-cm abdominal tumor. The woman then underwent a left salpingo-oophorectomy. Histological examination and immunohistochemical stains of the tumor confirmed the diagnosis of SFT. The patient recovered uneventfully and remained free of recurrence 6 months postoperatively.
CONCLUSION
SFTs in the female genital system are extremely rare and not fully understood. The metastatic risk of the patient was intermediate, according to the modified four-variable risk models based on the World Health Organization (WHO) classification of soft tissue tumors. Close monitoring with clinical evaluation and imaging studies will be conducted.
Topics: Humans; Female; Middle Aged; Ovary; Solitary Fibrous Tumors; Pelvis; Abdominal Neoplasms; Ultrasonography
PubMed: 36427978
DOI: 10.1016/j.tjog.2022.02.051 -
European Journal of Orthopaedic Surgery... Oct 2022Patients with pelvic and acetabular fractures often have considerable pain in the perioperative period. Regional anesthesia (RA) including peripheral nerve blocks and... (Observational Study)
Observational Study
INTRODUCTION
Patients with pelvic and acetabular fractures often have considerable pain in the perioperative period. Regional anesthesia (RA) including peripheral nerve blocks and spinal analgesia may reduce pain. However, the real-world impact of these modalities on inpatient opioid consumption and outpatient opioid demand is largely unknown. The purpose of this study was to evaluate the impact of perioperative RA on inpatient opioid consumption and outpatient opioid demand.
METHODS
This is a retrospective, observational review of inpatient opioid consumption and outpatient opioid demand in all patients ages 18 and older undergoing operative fixation of pelvic and acetabular fractures at a single Level, I trauma center from 7/1/2013-7/1/2018 (n = 205). Unadjusted and adjusted analyses were constructed to evaluate the impact of RA on inpatient opioid consumption and outpatient opioid demand while controlling for age, sex, race, body mass index (BMI), smoking, chronic opioid use, ASA score, injury mechanism, additional injuries, open injury, and additional inpatient surgery.
RESULTS
Adjusted models demonstrated increases in inpatient opioid consumption in patients with RA (12.6 estimated OE's without RA vs 16.1 OE's with RA from 48 to 72 h post-op, p < 0.05) but no significant differences at other timepoints (17.5 estimated OE's without RA vs 16.8 OE's with RA from 0 to 24 h post-op, 15.3 vs 17.1 from 24 to 48 h post-op, p > 0.05). Estimated cumulative outpatient opioid demand was significantly higher in patients with RA at discharge to 90 days post-op (and 156.8 vs 207.9 OE's to 90 days, p < 0.05) but did not differ significantly before that time (121.5 OE's without RA vs 123.9 with RA from discharge to two weeks, 145.2 vs 177.2 OE's to 6 weeks, p > 0.05).
DISCUSSION
In pelvis and acetabulum fracture surgery, RA was associated with increased inpatient and outpatient opioid demand after adjusting for baseline patient and treatment characteristics. Regional anesthesia may not be beneficial for these patients.
Topics: Acetabulum; Adolescent; Analgesics, Opioid; Anesthesia, Conduction; Hip Fractures; Humans; Pain; Pain, Postoperative; Pelvis; Retrospective Studies; Spinal Fractures
PubMed: 34519897
DOI: 10.1007/s00590-021-03114-w -
Skeletal Radiology May 2020Greater trochanteric pain syndrome (GTPS) is a condition resulting in lateral hip pain, most commonly caused by tendinosis or tear of the gluteus medius and minimus...
PURPOSE
Greater trochanteric pain syndrome (GTPS) is a condition resulting in lateral hip pain, most commonly caused by tendinosis or tear of the gluteus medius and minimus tendons, and greater trochanteric bursitis. Our aim was to assess pelvic parameters and proximal femoral anatomy in patients suffering from surgical-stage GTPS compared with a control group.
METHODS
This retrospective, case-control study assessed 43 patients suffering from GTPS, matched according to age, gender, body mass index and level of sport and physical activity to 43 control patients, between 2013 and 2018. Pelvic parameters, including pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS), and proximal femoral anatomy, including femoral offset (FO) and neck-shaft angle (NSA), were measured using the EOS Imaging™ system.
RESULTS
GTPS patients had a significantly lower mean (± SD) SS than control patients (33.1 ± 10.4 vs. 39.6 ± 9.7°, respectively; p < 0.05). There was no significant difference in PT (21.3 ± 7.1 vs. 19.0 ± 7.2°), PI (53.5 ± 11.6 vs. 57.7 ± 10.5°), FO (40.4 ± 8 vs. 42.2 ± 6.8°) or NSA (125.1 ± 5.8 vs. 124.4 ± 4.7°). There was no difference in lower back pain symptoms in a subgroup analysis of GTPS patients.
CONCLUSIONS
Sacral slope was lower in patients with surgical-stage GTPS than in asymptomatic hip patients, using the EOS Imaging™ system.
Topics: Aged; Back Pain; Bursitis; Case-Control Studies; Chronic Pain; Female; Femur; Hip Joint; Humans; Male; Pelvis; Radiography; Retrospective Studies; Sacrococcygeal Region; Syndrome; Tendinopathy
PubMed: 31828381
DOI: 10.1007/s00256-019-03359-x -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: A comparative analysis of the efficiency of the lumbo-pelvic-hip complex for bodybuilders and football referees. Defining factors that are related and those... (Comparative Study)
Comparative Study
OBJECTIVE
The aim: A comparative analysis of the efficiency of the lumbo-pelvic-hip complex for bodybuilders and football referees. Defining factors that are related and those that are not related to their professions that can affect their efficiency of the lumbo-pelvic-hip complex.
PATIENTS AND METHODS
Materials and methods: 35 bodybuilders and 41 football referees were randomly selected in different assosiations in Lodz. The study was performed using a questionnaire and tests for the SFTR range of motion of hip joints and also a Shober test.
RESULTS
Results: It occurs that statistically the extension, flexion, abduction, external and internal rotation were significant with bodybuilders and the extension and internal rotation movement with the referees. The mean values for the Shober test when moving forward were worse for the test group than man for the control group were correct. Alongside bulking within the test group and control group the range of motion in the hip joint has decreased. The biggest statistical significance has been for the flexion and internal rotation.
CONCLUSION
Conclusions: In the group of bodybuilders the restriction appears to be in 5 out of 6 type of movements in the hip joint area: extension, flexion, abduction, internal and external rotation. In the second group, football referees the range of motion forward and internal rotation is restricted. The mobility of the lumbar region in both groups is within the average, but for the bodybuilders at quite low. The efficiency of lumbo-pelvic-hip complex is determined by duration of training, body mass, type of training and also any pain ailments. Bodybuilders have less efficiency of lumbo-pelvic-hip complex.
Topics: Humans; Male; Biomechanical Phenomena; Football; Lumbosacral Region; Pelvis; Range of Motion, Articular
PubMed: 36591759
DOI: 10.36740/WLek202211202 -
Journal of Ultrasound in Medicine :... Feb 2018This study assessed the efficacy and safety of transvaginal ultrasound (US)-guided core needle biopsy (CNB) for obtaining adequate pelvic mass samples for histologic...
OBJECTIVES
This study assessed the efficacy and safety of transvaginal ultrasound (US)-guided core needle biopsy (CNB) for obtaining adequate pelvic mass samples for histologic analysis and evaluated factors that may affect biopsy success.
METHODS
Two hundred cases underwent transvaginal US-guided CNBs for primary inoperable tumors, suspicion of metastases to the ovaries or peritoneum, recurrence, or other solid lesions in the pelvis. Biopsy samples were obtained from the pelvic cavity (67.0%), vaginal cuff or vaginal wall (17.5%), or peritoneal cake (15.5%). The potential influences of the biopsy site (pelvic cavity, vaginal cuff or vaginal wall, or peritoneal cake), vascularization, ascites, tumor size, and tumor type (inoperable, metastases, recurrence, or solid pelvic tumor) on the success of transvaginal US-guided CNB were evaluated by a univariate analysis.
RESULTS
Adequate samples were obtained in 192 of 200 biopsies (96.0%), of which 190 yielded successful diagnoses (95.0%). The biopsy site had a significant effect on biopsy adequacy, as there was a significantly lower probability of obtaining satisfactory specimens for histologic verification from the peritoneal cake compared to pelvic tumors and the vaginal cuff or vaginal wall (P < .01). Adequacy was also affected by tumor size (P < .05) but not by vascularization, ascites, or tumor type. No complications occurred during the biopsy procedures.
CONCLUSIONS
Transvaginal US-guided CNB is a safe and effective alternative to more invasive methods for evaluating pelvic lesions, such as laparoscopy and laparotomy.
Topics: Adult; Biopsy, Large-Core Needle; Female; Humans; Image-Guided Biopsy; Middle Aged; Pelvic Neoplasms; Pelvis; Reproducibility of Results; Retrospective Studies; Ultrasonography, Interventional; Vagina
PubMed: 28885718
DOI: 10.1002/jum.14356 -
The Journal of Arthroplasty Oct 2023A postoperative change in pelvic flexion following total hip arthroplasty (THA) is considered to be one of the causes of dislocation. This study aimed to predict the...
BACKGROUND
A postoperative change in pelvic flexion following total hip arthroplasty (THA) is considered to be one of the causes of dislocation. This study aimed to predict the change of pelvic flexion after THA integrating preoperative and postoperative information with artificial intelligence.
METHODS
This study involved 415 hips which underwent primary THA. Pelvic flexion angle (PFA) is defined as the angle created by the anterior pelvic plane and the horizontal/vertical planes in the supine/standing positions, respectively. Changes in PFA from preoperative supine position to standing position at 5 years after THA were recorded and which were defined as a 5-year change in PFA. Machine learning analysis was performed to predict 5-year change in PFA less than -20° using demographic, blood biochemical, and radiographic data as explanatory variables. Decision trees were constructed based on the important predictors for 5-year change in PFA that can be handled by humans in clinical practice.
RESULTS
Among several machine learning models, random forest showed the highest accuracy (area under the curve = 0.852). Lumbo-lordotic angle, femoral anteversion angle, body mass index, pelvic tilt, and sacral slope were most important random forest predictors. By integrating these preoperative predictors with those obtained 1 year after the surgery, we developed a clinically applicable decision tree model that can predict 5-year change in PFA with area under the curve = 0.914.
CONCLUSION
A machine learning model to predict 5-year change in PFA after THA has been developed by integrating preoperative and postoperative patient information, which may have capabilities for preoperative planning of THA.
Topics: Humans; Arthroplasty, Replacement, Hip; Artificial Intelligence; Posture; Pelvis; Machine Learning
PubMed: 35788030
DOI: 10.1016/j.arth.2022.06.020 -
Radiographics : a Review Publication of... 2017Soft-tissue sarcomas are a diverse group of rare mesenchymal malignancies that can arise at any location in the body and affect all age groups. These sarcomas are most... (Review)
Review
Soft-tissue sarcomas are a diverse group of rare mesenchymal malignancies that can arise at any location in the body and affect all age groups. These sarcomas are most common in the extremities, trunk wall, retroperitoneum, and head and neck. In the adult population, soft-tissue sarcomas arising in the abdomen and pelvis are often large masses at the time of diagnosis because they are usually clinically silent or cause vague or mild symptoms until they invade or compress vital organs. In contrast, soft-tissue sarcomas arising from the abdominal wall come to clinical attention earlier in the course of disease because they cause a palpable mass, abdominal wall deformity, or pain that is more clinically apparent. The imaging features of abdominal and pelvic sarcomas and abdominal wall sarcomas can be nonspecific and overlap with more common pathologic conditions, making diagnosis difficult or, in some cases, delaying diagnosis. Liposarcoma (well-differentiated and dedifferentiated liposarcomas), leiomyosarcoma, and gastrointestinal stromal tumor (GIST) are the most common intra-abdominal primary sarcomas. Any soft-tissue sarcoma can arise in the abdominal wall. Knowledge of the classification and pathologic features of soft-tissue sarcomas, the anatomic locations where they occur, and their cross-sectional imaging features helps the radiologist establish the diagnosis or differential diagnosis so that patients with soft-tissue sarcomas can receive optimal treatment and management. In part 1 of this article, the most common soft-tissue sarcomas (liposarcoma, leiomyosarcoma, and GIST) are reviewed, with a discussion on anatomic locations, classification, clinical considerations, and differential diagnosis. Part 2 will focus on the remainder of the soft-tissue sarcomas occurring in the abdomen and pelvis.
Topics: Abdominal Cavity; Diagnosis, Differential; Humans; Pelvis; Sarcoma; Soft Tissue Neoplasms
PubMed: 28287938
DOI: 10.1148/rg.2017160157 -
Minerva Urologica E Nefrologica = the... Aug 2019To evaluate the factors including pelvic dimensions, which might influence operative difficulty and complications after open radical cystoprostatectomy and orthotopic...
BACKROUND
To evaluate the factors including pelvic dimensions, which might influence operative difficulty and complications after open radical cystoprostatectomy and orthotopic neobladder reconstruction in men.
METHODS
A total of 198 RC patients operated in our institution with preoperative magnetic resonance (MRI) were analyzed were included in the study. Pelvic dimensions, including interspinous distance (ISD), bony femoral - (BFW) and soft tissue width (SW), apical prostate depth (AD), upper conjugate (UC), lower conjugate (LC) were measured by preoperative MRI. BFW, ISD, and SW indexes were defined as BFW/AD, ISD/AD, and SW/AD, respectively. Complicatons were classified according to the Clavien-Dindo classification system. As indicators of surgical difficulty; transfusion rate (TR), estimated blood loss (EBL), operative time (OT) and hospital stay (HS) were assessed. SPSS version 17.0 was used for statistical analyses.
RESULTS
A total of 239 complications developed in 143 of the 198 patients (72.2%). Correlation analysis revealed a significant indirect relationship between TR and SW/AD (P=0.023). For EBL, there were significant indirect correlations between the SW/AD, BFW/AD and ISD/AD indexes (P=0.026, P=0.05, P=0.009; respectively). Additionally, OT was directly correlated body mass index (BMI) (P=0.001); and indirectly correlated with UC, SW/AD, and BFW/AD (P=0.047, P=0.038, P=0.016, respectively). On multivariate logistic regression analyses higher American Society of Anesthesiologist (ASA) score was associated with major complications. Multivariate analyses revealed that pathological stage was a significant predictor of EBL.
CONCLUSIONS
Patients with smaller pelvises might undergo more difficult surgeries. However, it seems that small sized pelvis does not impact on operative difficulty and complication rate in radical cystoprostatectomy and orthotopic neobladder.
Topics: Adult; Aged; Aged, 80 and over; Blood Loss, Surgical; Blood Transfusion; Humans; Length of Stay; Magnetic Resonance Imaging; Male; Middle Aged; Operative Time; Pelvis; Postoperative Complications; Prostate; Prostatectomy; Plastic Surgery Procedures; Urinary Bladder
PubMed: 31086130
DOI: 10.23736/S0393-2249.19.03195-3