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Neurosurgery Clinics of North America Jul 2018The pelvic incidence defines the amount of lordosis required in the lumbar spine, and a lumbar lordosis within 11° of the pelvic incidence defines alignment of the... (Review)
Review
The pelvic incidence defines the amount of lordosis required in the lumbar spine, and a lumbar lordosis within 11° of the pelvic incidence defines alignment of the lumbo-pelvic region. Pelvic tilt is a compensatory mechanism that allows patients to achieve sagittal balance in the setting of decreased lumbar lordosis with the primary compensatory mechanisms being hip extension and knee flexion. Planning an adult lumbar deformity operation requires a comprehensive history and physical examination and thorough radiographic evaluation with the goal of restoring alignment between the pelvic incidence and lumbar lordosis and restoring a normal pelvic tilt.
Topics: Humans; Lordosis; Lumbar Vertebrae; Lumbosacral Region; Pelvis; Preoperative Care
PubMed: 29933800
DOI: 10.1016/j.nec.2018.03.003 -
Orthopedic Nursing
Topics: Education, Nursing, Continuing; Fractures, Compression; Humans; Lumbosacral Region; Pain Management; Tomography, X-Ray Computed
PubMed: 33756540
DOI: 10.1097/NOR.0000000000000752 -
Neurosurgery Clinics of North America Jul 2019Lumbar isthmic spondylolisthesis is the anterior translation of one lumbar vertebra relative to the next caudal segment as a result of an abnormality in the pars... (Review)
Review
Lumbar isthmic spondylolisthesis is the anterior translation of one lumbar vertebra relative to the next caudal segment as a result of an abnormality in the pars interarticularis. Although it is most often an asymptomatic radiographic finding, symptomatic patients may present with low back and/or radicular leg pain. In the setting of persistent symptoms, despite nonoperative treatment, surgery can be considered. Successful arthrodesis and neurologic decompression, when necessary, are the chief goals of surgical treatment, which has demonstrated reasonable long-term outcomes. A variety of surgical treatment options are available and the relative efficacy of them based on patient-specific factors continue to be investigated.
Topics: Decompression, Surgical; Humans; Lumbar Vertebrae; Lumbosacral Region; Neurosurgical Procedures; Spondylolisthesis; Treatment Outcome
PubMed: 31078228
DOI: 10.1016/j.nec.2019.02.001 -
Medicine Sep 2022Intraspinal choristoma is a relatively uncommon intervertebral canal tumor. Prior to our reports, only 2 cases of intraspinal choristoma had been reported. Because this...
RATIONALE
Intraspinal choristoma is a relatively uncommon intervertebral canal tumor. Prior to our reports, only 2 cases of intraspinal choristoma had been reported. Because this disease is not common and looks like a mass of fatty tissue on the magnetic resonance imaging (MRI), intraspinal choristoma can be easily misdiagnosed as teratomas or lipomas (like the case of this article presenting) without a pathology report. So if a lumber intraspinal lesion is discovered in a clinical examination, intraspinal choristoma should be considered as a differential diagnosis. We present a case of intraspinal choristoma that is unlike any other reported case.
PATIENT CONCERNS
A 35-year-old woman with left lower extremity hypoesthesia and burning-like pain in the lumbar region for 1 month visited the local hospital for plain lumbar spine MRI. The patient was diagnosed with a lumbar space-occupying lesion. A second plain lumbar spine MRI scan and a MRI scan with enhancement were performed in our hospital to confirm the presence of a congenital lipoma in the spinal canal. A postoperative biopsy of the lumbar spinal mass indicated that the mass was an intraspinal choristoma located in the spinal canal.
DIAGNOSIS
Intraspinal choristoma.
INTERVENTION
The lesion was surgically removed, and follow-up plain and enhanced MRI images of the patient's lumbar spine were obtained.
OUTCOMES
After surgery, the patient no longer experienced the burning pain in her lumbar region or the left lower extremity hypoesthesia when the patient was discharged. And there was no evidence of recurrence 2 years after the surgery.
LESSONS
The MRI presentation of intraspinal choristoma is similar to intraspinal lipoma. Therefore, a pathological assessment is critical to provide an accurate diagnosis.
Topics: Adult; Choristoma; Female; Humans; Hypesthesia; Lipoma; Lumbar Vertebrae; Lumbosacral Region
PubMed: 36123848
DOI: 10.1097/MD.0000000000029350 -
Orthopedic Nursing
Topics: Fractures, Compression; Humans; Lumbosacral Region; Male; Middle Aged; Pain Management; Tomography, X-Ray Computed
PubMed: 33756539
DOI: 10.1097/NOR.0000000000000750 -
Spine Apr 2016When a patient presents with spine problems, the spine surgeon would do well to avoid use of, reliance on, and acceptance of radiographs as the sole or primary source of...
When a patient presents with spine problems, the spine surgeon would do well to avoid use of, reliance on, and acceptance of radiographs as the sole or primary source of information. Measurement of pelvic incidence and lumbar lordosis, although crucial, does not take into account the effort the patient must make to move, the level of involvement of other parts of the body, and the history of previous procedures and outcomes. Radiographs may show pathology that is not consistent with the appearance of the patient. How should we assess this situation?
Topics: Back Pain; Humans; Lumbar Vertebrae; Lumbosacral Region; Male; Osteotomy
PubMed: 27015064
DOI: 10.1097/BRS.0000000000001441 -
Journal of Neurosurgical Sciences Sep 2016The purpose of this study was to clarify the morphologic features, location and variations of the dorsal root ganglion (DRG). (Review)
Review
BACKGROUND
The purpose of this study was to clarify the morphologic features, location and variations of the dorsal root ganglion (DRG).
METHODS
Fifteen formalin fixed cadavers for the current study were included. Total of 150 DRGs were examined from L1 to L5. The relationships of the nerve root DRGs to the intervertebral foramen were noted. Position of the DRG was classified by the location of the ganglia in relation to the pedicle. The relationship of the DRG to the intervertebral foramen was evaluated.
RESULTS
The distance between the midpoint of the DRG to the cross section of the root with the medial border of the pedicle gradually increased from L1 to L5. The medial border of the foramen distances along the nerve root were L1, 1.77 mm; L2, 2.79 mm; L3, 3.23 mm; L4, 7.28 mm and L5, 8.31 mm. The mean width of the lumbar DRGs were L1, 4.36 mm; L2, 4.56 mm; L3, 4.99 mm; L4, 5.22 mm and L5, 5.82 mm. The mean length of DRGs were as follows: L1, 5.39 mm; L2, 5.83 mm; L3, 7.24 mm; L4, 7.97 mm and L5, 10.83 mm. The mean width and length of DRGs gradually increased from L1 to L5.
CONCLUSIONS
The DRG in the lumbar region play a key role in the occurence of low-back pain and sciatica; therefore, it is important to understand the anatomy of DRG. The accurate anatomic information about the position of DRGs would be useful to perform a safe surgical intervention in the lumbar foraminal region.
Topics: Cadaver; Ganglia, Spinal; Humans; Intervertebral Disc; Low Back Pain; Lumbar Vertebrae; Lumbosacral Region
PubMed: 27402404
DOI: No ID Found -
Asian Journal of Surgery Jan 2022
Topics: Diagnosis, Differential; Histiocytosis, Sinus; Humans; Lumbosacral Region
PubMed: 34635408
DOI: 10.1016/j.asjsur.2021.08.060 -
Neurosurgery Clinics of North America Jul 2018Alignment of the lumbar spine has an important impact on the segmental motion, degenerative pathology, and health-related quality of life. The relationship between... (Review)
Review
Alignment of the lumbar spine has an important impact on the segmental motion, degenerative pathology, and health-related quality of life. The relationship between lumbar lordosis and pelvic incidence is predictive in the pathogenesis of spinal disorders, including disk degeneration, spondylolisthesis, and adjacent segment degeneration. This article reviews the relationship between lumbar and pelvic alignment with pathology of the lumbar spine, provides goals for appropriate alignment in reconstructive surgery, and discusses strategies for effective realignment of the spine.
Topics: Humans; Lordosis; Lumbar Vertebrae; Lumbosacral Region; Spondylolisthesis
PubMed: 29933801
DOI: 10.1016/j.nec.2018.03.009 -
World Neurosurgery Jun 2017Scattered reports exist in the medical literature regarding facet tropism. However, this finding has had mixed conclusions regarding its origin and impact on the normal... (Review)
Review
BACKGROUND
Scattered reports exist in the medical literature regarding facet tropism. However, this finding has had mixed conclusions regarding its origin and impact on the normal spine.
METHODS
We performed a literature review of the anatomy, embryology, biomechanics, and pathology related to lumbar facet tropism.
RESULTS
Facet tropism is most commonly found at L4-L5 vertebral segments and there is some evidence that this condition may lead to facet degenerative spondylolisthesis, intervertebral disc disease, and other degenerative conditions.
CONCLUSION
Long-term analyses of patients are necessary to elucidate relationships between associated findings and facet tropism. In addition, a universally agreed definition that is more precise should be developed for future investigative studies.
Topics: Humans; Longitudinal Studies; Lumbar Vertebrae; Lumbosacral Region; Magnetic Resonance Imaging; Spondylolisthesis; Tropism; Zygapophyseal Joint
PubMed: 28279769
DOI: 10.1016/j.wneu.2017.02.114