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Annals of Medicine Oct 1989The magnitude of low back pain in terms of its occurrence and cost is reviewed. The biomechanics of the lumbar spine are related to the functional anatomy. The disparate... (Review)
Review
The magnitude of low back pain in terms of its occurrence and cost is reviewed. The biomechanics of the lumbar spine are related to the functional anatomy. The disparate functional mechanical requirements of the spine, support, mobility, housing, protection and control are reviewed. Typical forces one applies to the spine in activities of daily living as well as in mechanical overloads are discussed. The loads are broken down into tensile, compressive, shear and torsional loads. The posterior elements, the vertebral body and the intervertebral disc are reviewed separately and some implication in terms of the aetiology of low back pain is given. Finally, the behavior of the unit (the functional spinal unit) is discussed.
Topics: Back Pain; Biomechanical Phenomena; Humans; Intervertebral Disc; Lumbar Vertebrae; Motion
PubMed: 2532524
DOI: 10.3109/07853898909149219 -
Biomedical Physics & Engineering Express Nov 2021. Vertebrae models from computer tomographic (CT) imaging are extensively used in image-guided surgical systems to deliver percutaneous orthopaedic operations with...
. Vertebrae models from computer tomographic (CT) imaging are extensively used in image-guided surgical systems to deliver percutaneous orthopaedic operations with minimum risks, but patients may be exposed to excess radiation from the pre-operative CT scans. Generating vertebrae models from intra-operative x-rays for image-guided systems can reduce radiation exposure to the patient, and the surgeons can acquire the vertebrae's relative positions during the operation; therefore, we proposed a lumbar vertebrae reconstruction method from biplanar x-rays.. Non-stereo-corresponding vertebral landmarks on x-rays were identified as targets for deforming a set of template vertebrae; the deformation was formulated as a minimisation problem, and was solved using the augmented Lagrangian method. Mean surface errors between the models reconstructed using the proposed method and CT scans were measured to evaluate the reconstruction accuracy.. The evaluation yielded mean errors of 1.27 mm and 1.50 mm inexperiments on normal vertebrae and pathological vertebrae, respectively; the outcomes were comparable to other template-based methods.. The proposed method is a viable alternative to provide digital lumbar to be used in image-guided systems, where the models can be used as a visual reference in surgical planning and image-guided applications in operations where the reconstruction error is within the allowable surgical error.
Topics: Humans; Lumbar Vertebrae; Radiography; Tomography, X-Ray Computed; X-Rays
PubMed: 34700306
DOI: 10.1088/2057-1976/ac338c -
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 -
Archives of Disease in Childhood Feb 2006
Topics: Discitis; Humans; Infant; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Radiography
PubMed: 16428364
DOI: 10.1136/adc.2005.080804 -
MMW Fortschritte Der Medizin Jan 2019
Review
Topics: Biomechanical Phenomena; Humans; Lumbar Vertebrae; Lumbosacral Region; Range of Motion, Articular
PubMed: 30671823
DOI: 10.1007/s15006-019-0069-8 -
Operative Neurosurgery (Hagerstown, Md.) Jun 2021This review of the literature will focus on the indications, surgical techniques, and outcomes for expandable transforaminal lumbar interbody fusion (TLIF), anterior... (Review)
Review
This review of the literature will focus on the indications, surgical techniques, and outcomes for expandable transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), and lateral lumbar interbody fusion (LLIF) operations. The expandable TLIF cage has become a workhorse for common degenerative pathology, whereas expandable ALIF cages carry the promise of greater lordotic correction while evading the diseased posterior elements. Expandable LLIF cages call upon minimally invasive techniques for a retroperitoneal, transpsoas approach to the disc space, obviating the need for an access surgeon and decreasing risk of injury to the critical neurovascular structures. Nuances between expandable and static cages for all 3 TLIF, ALIF, and LLIF operations are discussed in this review.
Topics: Humans; Lordosis; Lumbar Vertebrae; Lumbosacral Region; Spinal Fusion; Technology
PubMed: 34128070
DOI: 10.1093/ons/opaa342 -
European Spine Journal : Official... Oct 2022Significant risk of injury to the lumbar plexus and its departing motor and sensory nerves exists with lateral lumbar interbody fusion (LLIF). Several cadaveric and... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Significant risk of injury to the lumbar plexus and its departing motor and sensory nerves exists with lateral lumbar interbody fusion (LLIF). Several cadaveric and imaging studies have investigated the lumbar plexus position with respect to the vertebral body anteroposterior plane. To date, no systematic review and meta-analysis of the lumbar plexus safe working zones for LLIF has been performed.
METHODS
This systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Relevant studies reporting on the position of the lumbar plexus with relation to the vertebral body in the anteroposterior plane were identified from a PubMed database query. Quantitative analysis was performed using Welch's t test.
RESULTS
Eighteen studies were included, encompassing 1005 subjects and 2472 intervertebral levels. Eleven studies used supine magnetic resonance imaging (MRI) with in vivo subjects. Seven studies used cadavers, five of which performed dissection in the left lateral decubitus position. A significant correlation (pā<ā0.001) existed between anterior lumbar plexus displacement and evaluation with in vivo MRI at all levels between L1-L5 compared with cadaveric measurement. Supine position was also associated with significant (pā<ā0.001) anterior shift of the lumbar plexus at all levels between L1-L5.
CONCLUSIONS
This is the first comprehensive systematic review and meta-analysis of the lumbar neural components and safe working zones for LLIF. Our analysis suggests that the lumbar plexus is significantly displaced ventrally with the supine compared to lateral decubitus position, and that MRI may overestimate ventral encroachment of lumbar plexus.
Topics: Cadaver; Humans; Lumbar Vertebrae; Lumbosacral Plexus; Psoas Muscles; Spinal Fusion
PubMed: 35984508
DOI: 10.1007/s00586-022-07352-2 -
Medicine, Science, and the Law Jan 2023Sex determination is a fundamental step in biological profile estimation from skeletal remains in forensic anthropology. This study proposes deep learning and...
Sex determination is a fundamental step in biological profile estimation from skeletal remains in forensic anthropology. This study proposes deep learning and morphometric technique to perform sex determination from lumbar vertebrae in a Thai population. A total of 1100 lumbar vertebrae (L1-L5) from 220 Thai individuals (110 males and 110 females) were obtained from the Forensic Osteology Research Center, Faculty of Medicine, Chiang Mai University, Thailand. In addition, two linear measurements of superior and inferior endplates from the digital caliper and image analysis were carried out for morphometric technique. Deep learning applied image classification to the superior and inferior endplates of the lumbar vertebral body. All lumbar vertebrae images are included in the dataset to increase the number of images per class. The accuracy determined the performance of each technique. The results showed the accuracies of 82.7%, 90.0%, and 92.5% for digital caliper, image analysis, and deep learning techniques, respectively. The lumbar vertebrae L1-L5 exhibit sexual dimorphism and can be used in sex estimation. Deep learning is more accurate in determining sex than the morphometric method. In addition, the subjectivity and errors in the measurement are decreased. Finally, this study presented an alternative approach to determining sex from lumbar vertebrae when the more traditionally used skeletal elements are incomplete or absent.
Topics: Male; Female; Humans; Lumbar Vertebrae; Thailand; Deep Learning; Southeast Asian People; Forensic Anthropology
PubMed: 35306907
DOI: 10.1177/00258024221089073 -
Clinical Spine Surgery May 2018Thoracolumbar burst fractures are high-energy vertebral injuries, which commonly can be treated nonoperatively. Consideration of the injury pattern, extent of... (Review)
Review
Thoracolumbar burst fractures are high-energy vertebral injuries, which commonly can be treated nonoperatively. Consideration of the injury pattern, extent of comminution, neurological status, and integrity of the posterior ligamentous complex may help determine whether operative management is appropriate. Several classification systems are contingent upon these factors to assist with clinical decision-making. A multitude of operative procedures have been shown to have good radiographic and clinical outcomes with extended follow-up, and treatment choice should be based on the individual's clinical and radiographic presentation.
Topics: Humans; Lumbar Vertebrae; Spinal Fractures; Thoracic Vertebrae
PubMed: 29578877
DOI: 10.1097/BSD.0000000000000634 -
Annual International Conference of the... Aug 2016Automatic and accurate lumbar vertebrae detection is an essential step of image-guided minimally invasive spine surgery (IG-MISS). However, traditional methods still...
Automatic and accurate lumbar vertebrae detection is an essential step of image-guided minimally invasive spine surgery (IG-MISS). However, traditional methods still require human intervention due to the similarity of vertebrae, abnormal pathological conditions and uncertain imaging angle. In this paper, we present a novel convolutional neural network (CNN) model to automatically detect lumbar vertebrae for C-arm X-ray images. Training data is augmented by DRR and automatic segmentation of ROI is able to reduce the computational complexity. Furthermore, a feature fusion deep learning (FFDL) model is introduced to combine two types of features of lumbar vertebrae X-ray images, which uses sobel kernel and Gabor kernel to obtain the contour and texture of lumbar vertebrae, respectively. Comprehensive qualitative and quantitative experiments demonstrate that our proposed model performs more accurate in abnormal cases with pathologies and surgical implants in multi-angle views.
Topics: Adult; Aged; Algorithms; Automation; Humans; Image Processing, Computer-Assisted; Lumbar Vertebrae; Middle Aged; Tomography, X-Ray Computed
PubMed: 28268411
DOI: 10.1109/EMBC.2016.7590785