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Central nervous system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The transverse processes project laterally from the junction of the pedicles and laminae. The superior articular process projects upwards from the junction of the pedicle and lamina and presents an articular facet that faces postero-laterally. The inferior articular process projects downwards and presents an articular facet that faces antero-medially. Typical vertebrae from each of the regions of the vertebral column are illustrated in Figs 11.35,11.36a–d.
How to perform revision lumbar decompression at the index level through a minimally invasive (MIS) approach
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Aaron Hillis, Christoph Wipplinger, Sertac Kirnaz, Franziska A. Schmidt, Roger Härtl
In patients whose symptoms can be related to lateral recess stenosis, the medial portion of the superior articular process is drilled and resected. However, care should be taken not to remove too much of the inferior articular process to avoid an iatrogenic fracture or secondary instability. In the next step, a Kerrison rongeur is used to trim the medial portion of the superior articular process until it is vertically flush with the medial border of the pedicle. The foramen can be opened up with the use of a curved-tip foraminotomy Kerrison rongeur. The ipsilateral side can be difficult to visualize directly, so it is important to establish a dissection plane above the nerve root by initial palpation with a blunt probe, and then to continue to work in the established plane using Kerrison rongeurs.
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
Thoracic vertebrae are the only ones with costal facets on the body and transverse processes for articulation with the ribs (see thoracic region – joints). Additionally, the orientation of the superior and inferior articular processes differs between the regions. In the thoracic region, the articular processes face posteriorly (superior processes) and anteriorly (inferior processes). This arrangement prevents flexion and extension from occurring in this region, but allows axial rotation. Lateral flexion is also possible, but is limited by the thoracic cage (see thoracic region – bones). In the lumbar vertebrae, the articular processes face posteromedially (superior) and anterolaterally (inferior). This provides rotational stability and allows flexion and extension to occur between adjacent vertebrae.
Ultrasound-guided axial facet joint interventions for chronic spinal pain: A narrative review
Published in Canadian Journal of Pain, 2023
Michael J. Wong, Manikandan Rajarathinam
Facet joints are paired joints formed by the superior articular process of one vertebra and the inferior articular process of the level above.29 The articular facets of these joints are covered with hyaline cartilage and enclosed in a synovial capsule, with the total volume of each facet joint being approximately 1 mL. Facet joints provide axial stability and define the spine’s range of motion at each region. Facet joint degenerative changes may involve bony hypertrophy, loss of cartilage and synovial fluid, and associated inflammation, which may all drive spinal pain.30 However, incidental and asymptomatic facet joint degeneration is also common,31 and joint capsular disruption may also cause pain in the absence of obvious radiographic changes.32
Evaluation of a rabbit model of adjacent intervertebral disc degeneration after fixation and fusion and maintenance in an upright feeding cage
Published in Neurological Research, 2021
Long Hei, Zhaohui Ge, Wenqi Yuan, Ling Suo, Zhigang Suo, Leilei Lin, Huiqiang Ding, Yusheng Qiu
There were seven dumbbell-shaped lumbar vertebrae in each rabbit. There was more cancellous bone near the endplates at both ends of the vertebral body, and less cancellous bone in the center of the vertebral body. Double layers of cortical bone extended and met posteriorly to constitute the anterior wall of the spinal canal. In general, the sagittal diameter and the coronal diameter gradually decreased from the two endplates to the middle of the vertebral body, and the coronal diameter of the vertebral body was larger than the sagittal diameter of the vertebral body. The intervertebral disc between the two vertebral bodies was located at the lower vertebral spinous process and articular process plane. The transverse processes were developed in a ‘V’ shape to form the attachment points of the dorsal longest muscle and other back muscles. The upper zygapophysis was relatively long, while the lower zygapophysis was relatively short; the adjacent upper and lower zygapophyses constituted the facet joints (Table 1). The anatomical structure of the vertebral body was used to select the appropriate screws (5 mm × 1.5 mm) and titanium plate (length: 20 mm). The lateral approach was preferred for titanium plate fixation, with an insertion point 2 mm from the inferior endplate of the vertebral body, and the entrance of the screw parallel to the coronal plane of the vertebral body.
Spinal biomechanics modeling and finite element analysis of surgical instrument interaction
Published in Computer Assisted Surgery, 2019
Weixing Guan, Yu Sun, Xiaozhi Qi, Ying Hu, Chunguang Duan, Huiren Tao, Xiaojun Yang
The lumbar vertebrae are mainly composed of vertebral body and intervertebral discs. And as shown in Figure 1, vertebral body mainly includes transverse processes, spinous processes, upper/lower articular process, vertebral foramen, lamina and papillae. The intervertebral disc is composed of the upper and lower endplates, the nucleus pulposus and the annulus fibrosus [1]. The upper and lower endplates are located at the bottom and top of the annulus fibrosus and they are the cartilage structure, which can be considered as elastic body. The nucleus pulposus is located in the middle of the annulus fibrosus, which is the incompressible fluid structure and belongs to the viscoelastic body and can withstand greater pressure. The annulus fibrosus which belongs to the super elastic body, surrounds the nucleus pulposus and connects the adjacent vertebrae through the upper and lower endplates [2,3]. The vertebral body consists of cortical bone and cancellous bone and the material parameters of the two parts are different [4].