BACKGROUND: Together with an increased interest in minimally invasive lateral transpsoas approach to the lumbar spine goes a demand for detailed anatomical descriptions of the lumbar plexus. Although definitions of safe zones and essential descriptions of topographical anatomy have been presented in several studies, the existing literature expects standard appearance of the neural structures. Therefore, the aim of this study was to investigate the variability of the extrapsoas portion of the lumbar plexus in regard to the lateral transpsoas approach. METHODS: A total of 260 lumbar regions from embalmed cadavers were utilized in this study. The specimens were dissected as per protocol and all nerves from the lumbar plexus were morphologically evaluated. RESULTS: The most common variation of the iliohypogastric and ilioinguinal nerves was fusion of these two nerves (9.6%). Nearly in the half of the cases (48.1%) the genitofemoral nerve left the psoas major muscle already divided into the femoral and genital branches. The lateral femoral cutaneous nerve was the least variable one as it resembled its normal morphology in 95.0% of cases. Regarding the variant origins of the femoral nerve, there was a low formation outside the psoas major muscle in 3.8% of cases. The obturator nerve was not variable at its emergence point but frequently branched (40.4%) before entering the obturator canal. In addition to the proper femoral and obturator nerves, accessory nerves were present in 12.3% and 9.2% of cases, respectively. CONCLUSION: Nerves of the lumbar plexus frequently show atypical anatomy outside the psoas major muscle. The presented study provides a compendious information source of the possibly encountered neural variations during retroperitoneal access to different segments of the lumbar spine.
- MeSH
- bederní obratle * chirurgie anatomie a histologie MeSH
- bederní svaly * anatomie a histologie chirurgie MeSH
- lidé MeSH
- miniinvazivní chirurgické výkony metody MeSH
- mrtvola * MeSH
- nervus femoralis anatomie a histologie chirurgie MeSH
- nervus obturatorius anatomie a histologie chirurgie MeSH
- plexus lumbosacralis * anatomie a histologie chirurgie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Vertebral measurements have been shown to provide accurate classification of sex. However, the use of vertebral discriminant functions (DFs) in forensic anthropology and bioarchaeology is limited due to the unknown degree of their population specificity. Additionally, the performance of vertebral DFs has not yet been assessed at higher posterior probability thresholds. In this study, we tested the performance of previously published DFs for sex classification from Th12 and L1 vertebrae within a range of 0.5-0.95 posterior probabilities in a model of geographically distant population based on an autopsy Central European (CE) sample (Czech Republic; n=72) from the 1930s. Further, we derived new pooled DFs from a sample representing ecogeographically diverse populations, new DFs derived from the autopsy CE sample, and new Medieval CE DFs derived from the Pohansko sample (n=129) and evaluated their performance at our testing autopsy CE sample. Most vertebral measurements showed population specificity in sex assessment. However, we identified two Th12 measurements (anteroposterior body diameter and mediolateral body diameter) usable for sex estimation across populations. We showed that the accuracy of vertebral DFs can be increased to 95% of correctly classified individuals in up to 64% of the studied sample by setting a higher posterior probability threshold. Finally, we showed that even the DFs derived from relatively small subsamples (30% of the population size) can provide accurate sex classification. This finding highlights the applicability of the hybrid approach in sex classification from vertebrae. To facilitate sex classification from vertebrae, we provide a software tool for sex classification from any vertebral measurement and reference samples tested in this study including the previously published DFs.
- MeSH
- bederní obratle anatomie a histologie MeSH
- diskriminační analýza MeSH
- hrudní obratle anatomie a histologie MeSH
- lidé MeSH
- soudní antropologie MeSH
- určení pohlaví podle kostry metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
One of the least known conditions of the lumbar spine in terms of biomechanics is spondylolisthesis which causes many serious consequences for the patient. This research aimed to perform a mechanical analysis of the origins of spondylolisthesis and its impact on the biomechanics of the lumbar section of the spine. Within the framework of this study, a physiologically model of the lumbar spine was created in the MADYMO software. In the next stage a slip of vertebra L4 was simulated by means of a controlled forward displacement of the vertebral body of vertebra L4. 10 variants of spondylolisthesis (W1–W10) of different degrees were subjected to a biomechanical evaluation. In maximum bending of the physiological spine at an angle of 27° the value of the shear force amounted to 1.9 kN, while for the spine affected by spondylolisthesis with slip grade W9 at the maximum bending of 34° the shear force amounted to 5.5 kN. It was observed that the lumbar spine with the simulated spondylolisthesis had greater mobility in comparison with the physiological spine, which was shown by maximum bending angles (physiological 27°, W9 34°).
The aim of this retrospective study of 330 rabbits (164 males, 166 females) was to determine different vertebral formulas and prevalence of congenital vertebral anomalies in rabbits from radiographs of the cervical (C), thoracic (Th), lumbar (L) and sacral (S) segments of the vertebral column. The number of vertebrae in each segment of vertebral column, position of anticlinal vertebra and localisation and type of congenital abnormalities were recorded. In 280/330 rabbits (84.8%) with normal vertebral morphology, seven vertebral formulas were identified: C7/Th12/L7/S4 (252/330, 76.4%), C7/Th12/L6/S4 (11/330, 3.3%), C7/Th13/L7/S4 (8/330, 2.4%), C7/Th12/L7/S5 (4/330, 1.2%), C7/Th12/L8/S4 (3/330, 0.9%), C7/Th12/L7/S6 (1/330, 0.3%) and C7/Th11/L7/S4 (1/330, 0.3%). The anticlinal vertebra was identified as Th10 in 56.4% of rabbits and Th11 in 42.4% of rabbits. Congenital spinal abnormalities were identified in 50/330 (15.2%) rabbits, predominantly as a single pathology (n=44). Transitional vertebrae represented the most common abnormalities (n=41 rabbits) in the thoracolumbar (n=35) and lumbosacral segments (n=6). Five variants of thoracolumbar transitional vertebrae were identified. Cervical butterfly vertebrae were detected in three rabbits. One rabbit exhibited three congenital vertebral anomalies: cervical block vertebra, thoracic hemivertebra and thoracolumbar transitional vertebra. Five rabbits exhibited congenital vertebral abnormalities with concurrent malalignment, specifically cervical kyphosis/short vertebra (n=1), thoracic lordoscoliosis/thoracolumbar transitional vertebrae (n=1), thoracic kyphoscoliosis/wedge vertebrae (n=2) and thoracolumbar lordoscoliosis/thoracolumbar transitional vertebrae/lumbosacral transitional vertebrae (n=1). These findings suggest that vertebral columns in rabbits display a wide range of morphologies, with occasional congenital malformations.
- MeSH
- bederní obratle abnormality anatomie a histologie MeSH
- hrudní obratle abnormality anatomie a histologie MeSH
- králíci * abnormality anatomie a histologie MeSH
- krční obratle abnormality anatomie a histologie MeSH
- křížová kost MeSH
- kyfóza diagnostické zobrazování veterinární MeSH
- rentgendiagnostika metody veterinární MeSH
- retrospektivní studie MeSH
- skolióza diagnostické zobrazování veterinární MeSH
- zvířata MeSH
- Check Tag
- králíci * abnormality anatomie a histologie MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Some data suggest that exposure to levetiracetam (LEV) might be associated with a risk for bone health in the model of orchidectomized rats. The aim of this study was to investigate if there is any significant risk of LEV for bone health in the model of gonadally intact animals. Wistar rats were divided into a control group and a test group, 8 rats in each group. The control rats received standard laboratory diet (SLD) while rats in the test group were fed SLD enriched with LEV for 12 weeks. Dual energy X-ray absorptiometry was used to measure BMD of the whole body, femur and lumbar vertebrae. The concentrations of bone markers were examined in bone homogenate. Both femurs and tibiae were used for biomechanical testing. We found in the LEV group significantly decreased absolute and relative values of adipose tissue, higher whole-body BMD, higher right tibia cortical thickness, and a significantly increased concentration of Bone Alkaline Phosphatase (BALP) and cross-linked C-telopeptide of type I collagen (CTX-I) compared with the control group. The results suggest that the long-term administration of LEV in the model of gonadally intact rats does not have a negative effect on bone. Significant increase in BMD and cortical thickness of the right tibia may indicate even a positive influence on the properties of bone. Further studies will be necessary in animals and humans to confirm these findings.
- MeSH
- bederní obratle anatomie a histologie účinky léků metabolismus fyziologie MeSH
- biologické markery metabolismus MeSH
- biomechanika účinky léků MeSH
- femur anatomie a histologie účinky léků metabolismus fyziologie MeSH
- kostní denzita účinky léků MeSH
- krysa rodu rattus MeSH
- piracetam analogy a deriváty farmakologie MeSH
- potkani Wistar MeSH
- tělesná hmotnost účinky léků MeSH
- velikost orgánu účinky léků MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Pain-provoking disorders of the lumbar spine affect most of adult population and nearly everyone suffers from some of them during their lifetime. A common symptom of diseases, injuries or inevitable changes in the area of lumbar spine is known as the Low Back Pain (LBP). A chronic form of the LBP, called the Low Back Pain syndrome, is mostly caused by degenerative changes of intervertebral discs of the lowest intervertebral joints. The work was focused on in vitro analysis of the porcine lumbar spine kinematics. Two last neighbouring intervertebral joints without active tissue, L4/5 and L5/6, were used. The total number of fifteen cadaveric samples of porcine lumbar spine was involved. A unique loading mechanism was designed and constructed for the purposes of this study. Samples were loaded by flexion/extension movement within the physiological range of motion of ± 5°, in a quasi-static mode. The recording and analysing of the lumbar spine kinematics was realized by the motion capture camera system (Qualisys AB, Göteborg, Sweden). The results showed that the so-called instantaneous axis of rotation (IAR), or the corresponding instantaneous centre of rotation (ICR), was an adequate objective parameter for the assessment of the lumbar spine kinematics. Its position was comparable across all samples and situated very close to the spinal canal. For the purposes of this work, an altered artificial disc of a ball-and-socket type (ProSpon, Ltd., Kladno, Czech Republic) was used to study the kinematics of two neighbouring joints after the disc replacement in the area of a caudally situated one. The results of this comparative analysis showed a significant influence of the artificial disc on the kinematics of both, caudally situated joint, where the disc was implanted, and the adjacent one.
- MeSH
- bederní obratle anatomie a histologie fyziologie MeSH
- biologické modely MeSH
- bolesti zad * etiologie patofyziologie MeSH
- kinetika MeSH
- lidé MeSH
- lumbalgie MeSH
- rotace MeSH
- točivý moment MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
V literatúre správy o výskyte prechodového lumbosakrálneho stavca v populácii sú v rozpätí 4-36 %. Toto široké rozpätie je v dôsledku rozdielnej diagnostiky a klasifikačných kritérií. Sakralizácia L5 je bežnejšou ako lumbalizácia a jej výskyt je od 1,7-14 % (4). Prechodové stavy stavca L5 obsahujú niekoľko stupňov artikulačnych spojení medzi transverzálnymi výbežkami L5 a prvým sakrálnym segmentom. Castellvi klasifikoval variácie lumbosakrálneho prechodového stavca do štyroch skupín: typ I – dysplastický procesus transversus, typ II – inkompletná lumbalizácia/sakralizácia s unilaterálnou alebo bilaterálnou pseusoartrózou, typ III – kompletná lumbalizácia/ sakralizácia, typ IV – kombinovaná (4). Asymetrická sakralizácia alebo lumbalizácia (tzv. megatransverzus alebo Bartolottiho syndróm) je pravdepodobne zdrojom chronických bolestí. Neoarthros medzi hypertrofickým priečnym výbežkom na jednej strane, atypicky zaťažovaný, páčený kĺb na protiľahlej strane, alebo preťažený segment nad postihnutým miestom, ktoré má minimálnu pohyblivosť, môžu byť rôznou mierou zdrojom chronických bolestí (2). Predkladáme kazuistiku 50-ročnej pacientky s chronickými bolesťami chrbta, ktorej sme zistili kompletnú fúziu L5- S1 segmentu, III. st. podľa Castellviho. Po komplexnej rehabilitačnej liečbe došlo k úprave ťažkostí pacientky, ale domnievame sa, že je riziková. Preťažovanie vyšších segmentov nad blokom, ktoré kompenzujú stratu jedného segmentu, vedú k akcelerácii degeneratívnych zmien a lézii intervertebrálneho disku v lumbálnej oblasti až s možným rozvojom radikulárneho syndrómu.
The literature on the occurrence of transition lumbosacral vertebra in the population reports the range of 4 and 36%. This wide range result from differential approaches to diagnosis and classification criteria. Sacralization of L5 is more common than lumbarization and occurs in the range of 1.7 to 14% (4). The transition states of vertebra L5 include several degrees of articular connections between transversal processus L5 and the first sacral segment. Castellvi classified variations of lumbosacral transition of vertebra into four groups: Type I – dysplastic processus transversus, type II – incomplete lumbarization/sacralizátion with unilateral or bilateral pseudoarthrosis, type III – complete lumbarization/ sacralization, and type IV – combined state (4). Asymmetric sacralization or lumbarization (sc. megatransversus or Bartolotti’s syndrome) is probably the source of chronic pain. Neoarthrosis between hypertrophic transversal processus on one side, atypically loaded, pried/levered/wrested joint on the opposite side or overloaded segment above the affected side, where mobility is minimal, can be the source of chronic pain in various degree (2). The reported case concerns a 50 year female patient with chronic spine pain, where we determined a complete fusion of L5-S1 segment of IIIrd degree according to Castellvi. A complex rehabilitation therapy resulted in adjustment of the patient’s complains, but in our opinion that the patient is at risk. Overload of high segments above the block, which compensates the loss of one segment, follows to acceleration of degenerative changes and lesions of intervertebral disk in lumbar region up to possible development of radicular syndrome.
Amyotrofická laterální skleróza (ALS) je neurodegenerativní onemocnění, které se vyznačuje progresivním postižením horního i dolního motoneuronu. ALS má často fokální začátek a vyznačuje se širokou diferenciální diagnostikou zejména v počátečních stadiích onemocnění, kdy klinický i elektrofyziologický obraz není plně rozvinutý. Popisovaná kazuistika upozorňuje na možnost záměny počátečního stadia ALS s lumbální spinální stenózou, což vedlo i k neindikované operaci bederní páteře, dále také zdůrazňuje nutnost opatrného hodnocení degenerativních změn na páteři jako kauzální příčiny neurologických potíží.
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterised by progressive impairment of upper and lower motor neurons. The typical sign of ALS is focal onset. The differential diagnosis of ALS, especially in the early stage of the disease when clinical and electrophysiological abnormalities are not fully developed, is wide. We present a case report that describes mistaking diagnosis of ALS in early stage for lumbar spinal stenosis that resulted in not indicated surgery. This case report emphasises the necessity of careful evaluation of degenerative impairment of spine as the main cause of neurological problems.
- MeSH
- amyotrofická laterální skleróza * diagnóza patofyziologie patologie MeSH
- bederní obratle anatomie a histologie patofyziologie patologie MeSH
- diagnostické zobrazování metody využití MeSH
- diferenciální diagnóza * MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody využití MeSH
- neurochirurgické výkony metody využití MeSH
- neurologické manifestace MeSH
- přežití MeSH
- prognóza MeSH
- senioři MeSH
- spinální stenóza * diagnóza etiologie patofyziologie MeSH
- statistika jako téma MeSH
- zbytečná diagnóza a terapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Cílem předkládané práce je shrnout současné základní poznatky o degenerativním onemocnění bederní páteře se zaměřením na epidemiologii, anatomii, etiopatogenezi a vymezit základní dosud známé diagnostické jednotky jako výchozí předpoklad pro další kroky v procesu zkoumání a posléze posuzování a uznávání profesionality onemocnění bederní páteře.
The article summarizes present basic knowledge of degenerative diseases of lumbar spine concerning epidemiology, anatomy, etiopathogenesis and outlines basic so far known diagnostic units as initial presumption for further steps in the process of investigation and subsequently the assessment and acknowledgement of occupational origin of the lumbar spine diseases.
- MeSH
- bederní obratle * anatomie a histologie fyziologie MeSH
- chronická nemoc MeSH
- degenerace meziobratlové ploténky etiologie MeSH
- diferenciální diagnóza MeSH
- difuzní idiopatická skeletální hyperostóza etiologie MeSH
- lidé MeSH
- lumbalgie epidemiologie etiologie MeSH
- meziobratlová ploténka anatomie a histologie MeSH
- nemoci páteře * diagnóza epidemiologie etiologie MeSH
- nemoci z povolání MeSH
- poranění z opakovaného přetěžování * MeSH
- spinální stenóza diagnóza etiologie MeSH
- spondylartritida diagnóza etiologie MeSH
- spondylolistéza diagnóza etiologie MeSH
- spondylolýza diagnóza etiologie MeSH
- spondylóza diagnóza etiologie MeSH
- výhřez meziobratlové ploténky diagnóza etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
In our study we focused on the axial rotation of vertebra in transversal plane, because of its important part in development of scoliosis. We have studied the mutual motion of two adjacent vertebrae. If the position of the lower vertebra in the transversal cross-section is regarded as the starting position, then the position of the upper vertebra is described as a result of rotation along the centre of rotation. We were interested in potential fulcrum positions of rotation with regard to the safety of spinal cord that can be endangered by change of spinal canal cross section. From transversal MRI cuts of idiopathic scoliosis we measured real dimensions of spinal cord and canal in thoracic and lumbar spine. Vertebrae rotation was verified by means of simple geometric 2D models with various positions of rotation centres. We applied real average parameters of thoracic and lumbar vertebra. Rotation angles in the models were selected with regard to the range of particular rotations during common movement of healthy spine – 6°/3° thoracic/lumbar vertebra. Further, rotation of thoracic vertebra by 15° was chosen, which is rotation characteristic of scoliosis. The results showed that usually used centre of rotation in the middle of vertebral body is not applicable.
- MeSH
- bederní obratle abnormality anatomie a histologie diagnostické zobrazování MeSH
- hrudní obratle abnormality anatomie a histologie diagnostické zobrazování MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- modely strukturální MeSH
- páteř abnormality anatomie a histologie diagnostické zobrazování MeSH
- rotace MeSH
- skolióza diagnostické zobrazování MeSH
- torzní deformity diagnostické zobrazování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
