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Journal of Digital Imaging Feb 2020Patient-specific 3D modeling is the first step towards image-guided surgery, the actual revolution in surgical care. Pediatric and adolescent patients with rare tumors... (Review)
Review
Patient-specific 3D modeling is the first step towards image-guided surgery, the actual revolution in surgical care. Pediatric and adolescent patients with rare tumors and malformations should highly benefit from these latest technological innovations, allowing personalized tailored surgery. This study focused on the pelvic region, located at the crossroads of the urinary, digestive, and genital channels with important vascular and nervous structures. The aim of this study was to evaluate the performances of different software tools to obtain patient-specific 3D models, through segmentation of magnetic resonance images (MRI), the reference for pediatric pelvis examination. Twelve software tools freely available on the Internet and two commercial software tools were evaluated using T2-w MRI and diffusion-weighted MRI images. The software tools were rated according to eight criteria, evaluated by three different users: automatization degree, segmentation time, usability, 3D visualization, presence of image registration tools, tractography tools, supported OS, and potential extension (i.e., plugins). A ranking of software tools for 3D modeling of MRI medical images, according to the set of predefined criteria, was given. This ranking allowed us to elaborate guidelines for the choice of software tools for pelvic surgical planning in pediatric patients. The best-ranked software tools were Myrian Studio, ITK-SNAP, and 3D Slicer, the latter being especially appropriate if nerve fibers should be included in the 3D patient model. To conclude, this study proposed a comprehensive review of software tools for 3D modeling of the pelvis according to a set of eight criteria and delivered specific conclusions for pediatric and adolescent patients that can be directly applied to clinical practice.
Topics: Humans; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Pelvis; Software; Surgery, Computer-Assisted
PubMed: 31236743
DOI: 10.1007/s10278-019-00239-7 -
BMC Musculoskeletal Disorders Feb 2022Pelvic incidence (PI) is used as a key parameter in surgical correction of adult spinal deformity (ASD). However, reflecting the exact center or inclination of the...
BACKGROUND
Pelvic incidence (PI) is used as a key parameter in surgical correction of adult spinal deformity (ASD). However, reflecting the exact center or inclination of the three-dimensional anatomical structures on the two-dimensional (2D) sagittal radiographs is limited, resulting in measurement errors. Therefore, we evaluated whether there is a change in PI measurement according to the actual rotation of the pelvis, and conducted a study on a more accurate method for PI measurement using 2D sagittal radiographs.
METHODS
From 2014 to 2015, the data of 30 patients who visited our outpatient clinic were analyzed retrospectively. CT scans including those of the lower lumbar spine, pelvis, and both femurs in the DICOM format were imported to Mimics Research 17.0 (Materialise NV, Belgium), SolidWorks (Dassault systems, France), and AutoCAD 2014 (AUTODESK, US). The changes in PI according to vertical and horizontal pelvic rotations were evaluated.
RESULTS
The average PIs according to the horizontal pelvic rotations measured on AutoCAD with 0°, 5°, 10°, 15°, 20°, 25°, 30°, 35°, and 40° were 48.8°, 48.7°, 48.3°, 47.8°, 46.9°, 45.6°, 44.0°, 42.2°, and 39.9°, respectively. The PI with an acceptable error of 6° on radiographs was 35° in the horizontal pelvic rotation. The average PIs according to the vertical pelvic rotations measured on AutoCAD with 0°, 5°, 10°, 15°, 20°, 25°, 30°, 35°, and 40° were 48.8°, 49.0°, 49.5°, 50.2°, 51.3°, 52.7°, 54.4°, 56.6°, and 59.4°, respectively. The PI with an acceptable error of 6° on radiographs was 30° in the vertical pelvic rotation.
CONCLUSIONS
This study revealed that the PI value could differ from the actual anatomical value due to the horizontal and vertical rotation of the pelvis while acquiring the radiograph. Regarding whole-spine lateral radiographs, errors in PI measurement may occur due to pelvic rotation or nonvertical projection of X-rays. In the standing pelvic lateral radiographs, ensuring superposition of the femoral heads at the center and obtaining the straight sacral endplate by referring to CT or magnetic resonance imaging would be a more accurate measurement method to define PI.
Topics: Adult; Femur Head; Humans; Pelvis; Radiography; Retrospective Studies; Sacrum
PubMed: 35109846
DOI: 10.1186/s12891-022-05063-9 -
BioMed Research International 2022This study was aimed at investigating the effect of pelvic tilt taping on muscle strength, pelvic inclination, and gait function in patients with stroke. (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of Pelvic Stabilization Training with Lateral and Posterior Tilt Taping on Pelvic Inclination, Muscle Strength, and Gait Function in Patients with Stroke: A Randomized Controlled Study.
BACKGROUND
This study was aimed at investigating the effect of pelvic tilt taping on muscle strength, pelvic inclination, and gait function in patients with stroke.
METHODS
A total of 60 patients with stroke were included in our study and randomly divided into three groups: the posterior pelvic tilt taping (PPTT, = 20), the lateral pelvic tilt taping (LPPP) with PPTT (LPPP+PPTT, = 20), and the control ( = 20) groups. All participants performed pelvic stabilization exercises consisting of 6 movements: supine, side lying, quadruped, sitting, squatting, and standing (30 min/day, five days/week, for six weeks). PPTT to correct anterior pelvic tilt was applied to the LPTT+PPTT and PPTT groups, and lateral pelvic tilt taping was additionally applied to the LPTT+PPTT group. LPTT was performed to correct the pelvis tilted to the affected side, and PPTT was performed to correct the anterior pelvic tilt. The control group did not undergo taping. A hand-held dynamometer was used to measure the hip abductor muscle strength. In addition, a palpation meter and 10-meter walk test were used to assess pelvic inclination and gait function.
RESULTS
Muscle strength was significantly stronger in the LPTT+PPTT group than in the other two groups ( = 0.01). The anterior pelvic tilt was significantly improved in the taping group compared to the control group ( < 0.001), and the lateral pelvic tilt was significantly improved in the LPTT+PPTT group compared to the other two groups ( < 0.001). Significantly greater improvements in gait speed were observed in the LPTT+PPTT group than in the other two groups ( = 0.02).
CONCLUSIONS
PPPT can significantly affect pelvic alignment and walking speed in patients with stroke, and the additional application of LPTT can further strengthen these effects. Therefore, we suggest using taping as an auxiliary therapeutic-intervention method in postural control training.
Topics: Humans; Pelvis; Posture; Gait; Stroke; Muscle Strength
PubMed: 37333857
DOI: 10.1155/2022/9224668 -
Scientific Reports Aug 2019The objectives of the study were to evaluate the correctness of the body posture of female soccer players in the frontal plane from the back based on selected body... (Observational Study)
Observational Study
The objectives of the study were to evaluate the correctness of the body posture of female soccer players in the frontal plane from the back based on selected body points in two static positions (habitual and actively corrected) using a non-contact optical measurement method. Forty-two young women (aged 16-20) playing soccer in a sports club in Poland were examined and compared with controls. The spatial coordinates (x, y, z) of the selected body points were determined. Four points (Oc, Oc, Pv and Pv) were extracted and used to calculate vectors [Formula: see text] and [Formula: see text] for analysis. The results show that median of the pelvic line angle was positive (Pv was lower than Pv) in both groups. For the habitual posture, the absolute value of the difference between the 25th and 75th percentiles in the pelvic line was almost three times greater among the soccer players than the controls (ratio between soccer players and controls: 2.93). Static postural imbalances in female soccer players require diagnosis of the sacroiliac joints with analysis of lumbar-pelvic system support and inhibition in the context of myofascial connection integration. Exercises can be implemented to stabilize the lumbar-pelvis complex as prophylaxis for spinal overload during the training cycle.
Topics: Adolescent; Anthropometry; Athletes; Female; Humans; Pelvis; Poland; Postural Balance; Posture; Sacroiliac Joint; Soccer; Young Adult
PubMed: 31371759
DOI: 10.1038/s41598-019-47619-1 -
Anatomy of the vesicovaginal fascia and its relation to branches of the inferior hypogastric plexus.Clinical Anatomy (New York, N.Y.) Oct 2022The inferior hypogastric plexus (IHP) lies in the extraperitoneal pelvis, and supplies branches to pelvic and perineal viscera. In men, the rectoprostatic fascia...
The inferior hypogastric plexus (IHP) lies in the extraperitoneal pelvis, and supplies branches to pelvic and perineal viscera. In men, the rectoprostatic fascia (Denonvillier's fascia) forms a distinct double fascial layer between the seminal glands and the rectum. The hypogastric nerve projections to the prostate and seminal glands run anterior to this. An analagous fascial layer in women between the vagina and cervix posteriorly and the urinary bladder anteriorly has recently been described. The purpose of this study was to examine the anatomy of the vesicovaginal fascia (VVF) and to determine its relationship to the anterior branches of the IHP. This dissection study examined the fascial layers between the posterior urinary bladder and anterior vagina/cervix (VVF) in 15 female embalmed cadavers and three fresh specimens. Anterior branches of the IHP were identified and followed distally. The relationship between these nerve projections and the VVF was examined. In 16 dissection, the VVF was identified as a complete fascial plane extending beneath the vesicouterine pouch to the neck of the bladder inferiorly and to the endopelvic fascia laterally. Anterior projections from the hypogastric nerves and IHP maintained an extraperitoneal course passing anteriorly to the VVF towards the urinary bladder The VVF is a distinct fascial structure and projections of the hypogastric nerves pass anterior to this. This may have implications for nerve sparing hysterectomy.
Topics: Fascia; Female; Humans; Hypogastric Plexus; Male; Pelvis; Rectum; Urinary Bladder
PubMed: 35333406
DOI: 10.1002/ca.23858 -
Acta Veterinaria Scandinavica Aug 2022The computed tomography (CT) and ultrasonography (US) features of lymph nodes of the abdomen, pelvis, and hindlimb in healthy cats are poorly described in the current...
BACKGROUND
The computed tomography (CT) and ultrasonography (US) features of lymph nodes of the abdomen, pelvis, and hindlimb in healthy cats are poorly described in the current literature. A prospective anatomic and reference interval study was therefore performed. The lymph nodes of six feline cadavers were identified, and dimensions were measured (length, width, and height). The lymph nodes from 30 healthy adult cats were identified and measured using CT (pre- and postcontrast) and US. The identification and dimensions of the separate lymph nodes were compared between imaging techniques and the anatomic study.
RESULTS
The identification of lymph nodes was most frequent in CT, and the dimensions were overall larger than those identified and measured in US and the anatomic study. The caudal epigastric and sacral lymph nodes were not identified in the anatomic study. The ischiatic, lumbar aortic, internal iliac, and caudal epigastric lymph nodes were not visualized in US. The height presented the main statistical differences among techniques. The lymph nodes were mainly homogeneous in pre- and postcontrast CT and US images. Some lymph nodes showed a hyperattenuating periphery with a hypoattenuating center (on pre- and postcontrast images) and a hypo-/isoechoic periphery with a hyperechoic center, representing the hilar fat. The lymph nodes were commonly elongated and rounded except for the jejunal lymph nodes, which had an irregular shape.
CONCLUSIONS
The assessment of most of the abdominal, pelvic, and hindlimb lymph nodes in the cat is feasible using CT and US, with CT performing best. Factors like the amount of adipose tissue and contrast administration subjectively improved the lymph node visualization and assessment. The measurements and features reported are proposed as reference values.
Topics: Abdomen; Animals; Cats; Hindlimb; Lymph Nodes; Pelvis; Prospective Studies; Tomography, X-Ray Computed
PubMed: 35964104
DOI: 10.1186/s13028-022-00638-x -
The Pan African Medical Journal 2023posterior urethral injuries can occur in polytrauma settings, and may contribute to morbidity post-trauma. The aim of this study is to determine the occurrence of pelvic...
Epidemiology of posterior urethral injury among adults with traumatic pelvic ring disruptions: a 10-year retrospective review from a trauma care centre in Southeast Nigeria.
INTRODUCTION
posterior urethral injuries can occur in polytrauma settings, and may contribute to morbidity post-trauma. The aim of this study is to determine the occurrence of pelvic fracture urethral injury (PFUI) in adult polytrauma patients who were successfully stabilized and to appraise the nature of associated injuries.
METHODS
the medical records of stabilized polytrauma patients≥ 18 years of age from January 2010 to December 2019 were retrospectively reviewed focusing on those presenting with bony pelvis disruptions. Injuries were categorized using the injury severity scale (ISS) while bony pelvis disruptions were classed according to the Young-Burgess classification. Data on the demography of the patient, mechanism of injury, nature, and severity of injuries, class of pelvic fracture-disruption, and urethral integrity were collected and analyzed accordingly.
RESULTS
of 111 patients with bony pelvis disruptions, 95 of them had adequate information and were included in our analysis. The mean age of participants was 37.3 ± 11.8 years and most of them were males (87.4%). Blunt pelvic trauma occurred in 96.8%. Lateral compression pelvic injuries were prevalent at 39.0%. In 54.7% of the patients, the injury severity score (ISS) was ≥ 27. At 25.3% and 24.2% respectively, the abdomen and the lower extremities most frequently sustained a grade ≥ 3 injuries (abbreviated injury scale (AIS) ≥3). At a rate of 2.1%, spinal cord injury was the least observed. In the 10 years, there were 6 PFUI among 83 stabilized polytraumatized men with mean ISS of 35.5 ± 8.3. The incidence rate of PFUI was 0.6 per 8.3 pelvic disruptions in men per year. Symphysis pubis disruption or fracture of the pubis or both was consistently seen in all PFUI. Higher ISS significantly relates to PFUI (p <0.001). The mechanism of bony pelvis disruption and the class of bony pelvis injury are determined by the severity and trajectory of the impact apparently relates to PFUI only through fracture-disruption of the pubic symphysis or the pubis.
CONCLUSION
about 7.2% of men presenting with traumatic disruption of the bony pelvis in polytrauma setting sustain PFUI. In polytrauma settings, PFUI should be suspected in cases of fracture-disruption of the pubis or symphysis pubis from any mechanism.
Topics: Male; Humans; Adult; Middle Aged; Female; Retrospective Studies; Nigeria; Pelvis; Fractures, Bone; Pelvic Bones; Urethral Diseases; Multiple Trauma; Wounds, Nonpenetrating; Emergency Medical Services
PubMed: 37575524
DOI: 10.11604/pamj.2023.45.43.34603 -
PloS One 2022Few studies have analyzed the different biomechanical properties of the lumbar with various morphological parameters, which play an important role in injury and...
BACKGROUND
Few studies have analyzed the different biomechanical properties of the lumbar with various morphological parameters, which play an important role in injury and degeneration. This study aims to preliminarily investigate biomechanical characteristics of the spine with different sagittal alignment morphotypes by using finite element (FE) simulation and in-vitro testing.
METHODS
According to the lumbar-pelvic radiographic parameters of the Chinese population, the parametric FE models (L1-S1-pelvis) of Roussouly's type (1-4) were validated and developed based on the in-vitro biomechanical testing. A pure moment of 7.5 Nm was applied in the three anatomical planes to simulate the physiological activities of flexion, extension, left-right lateral bending and left-right axial rotation.
RESULTS
The sagittal configuration of four Roussouly's type models had a strong effect on the biomechanical responses in flexion and extension. The apex of the lumbar lordosis is a critical position where the segment has the lowest range of motion among all the models. In flexion-extension, type 3 and 4 models with a good lordosis shape had a more uniform rotation distribution at each motor function segment, however, type 1 and 2 models with a straighter spine had a larger proportion of rotation at the L5-S1 level. In addition, type 1 and 2 models had higher intradiscal pressures (IDPs) at the L4-5 segment in flexion, while type 4 model had larger matrix and fiber stresses at the L5-S1 segment in extension.
CONCLUSION
The well-marched lordotic type 3 lumbar had greater stability, however, a straighter spine (type 1 and 2) had poor balance and load-bearing capacity. The hypolordotic type 4 model showed larger annulus fiber stress. Therefore, the sagittal alignment of Roussouly's type models had different kinetic and biomechanical responses under various loading conditions, leading to different clinical manifestations of the lumbar disease.
Topics: Biomechanical Phenomena; Finite Element Analysis; Humans; Lordosis; Lumbar Vertebrae; Pelvis; Range of Motion, Articular; Spinal Fusion; Weight-Bearing
PubMed: 35905050
DOI: 10.1371/journal.pone.0266954 -
Atencion Primaria May 2023
Topics: Humans; Infant; Candida; Skin; Pelvis
PubMed: 37030075
DOI: 10.1016/j.aprim.2023.102621 -
The British Journal of Surgery Dec 2019
Topics: Abdomen; Colon; England; History, 19th Century; History, 20th Century; Hospitals; Humans; Pelvis; Rectum; Surgical Instruments
PubMed: 31747072
DOI: 10.1002/bjs.11188