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Skeletal, Muscle, Brain, etc. Deposits and some Isotope Procedures.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Within the spine, absent spinous processes or pedicles may indicate the presence of a deposit, but not uncommonly a spinous process is congenitally absent in the lower dorsal spine (most often at D 12 level). Adjacent soft tissue masses are common - see ps. 18.28 - 29. A point worth emphasising is that single views of the spine are inadequate for the diagnosis of metastases - gross lesions are easily missed (see also Davies, A. et al, 1993, Tyrrell et al., 1995, Whitehouse, 1995 and Blease, 1995).
Low Back Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Prolapse of the lumbar intervertebral disc: The location of the pain is on the spinous process.The pain radiates to the leg along the dermatomal distributions.Cough and sneezing increase pain.Straight leg raise test is positive.44
Spine
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
A typical vertebra has a vertebral body situated anteriorly and the vertebral arch posterolaterally thereby enclosing the vertebral canal containing the spinal cord. Vertebral body – anterior and weight bearingVertebral arch made of Two transverse processes – posterolateral projectionsTwo pedicles connecting the body to the transverse processSingle spinous process posteriorlyTwo laminae – between transverse process and spinous processThe intervertebral foramina are present between the successive pedicles and transmit the spinal nerve and radicular vesselsSuperior and inferior articular processes with their articular facets connect adjacent vertebral arches
Ultrasound -guided erector spinae plane block (ESPB) versus intravenous opioids based analgesia in patients with rib fractures
Published in Egyptian Journal of Anaesthesia, 2023
Soha Elmansy, Mohammed Abdelkhalek, Sherif Farouk, Randa Shoukry, Ahmed Khames
Patients in this group received ESPB, which was administered in a lateral decubitus position. Patients received IV midazolam (0.05 mg/kg) to safely perform the procedure. The desired vertebral level corresponded to the middle of the extent of the broken ribs. The linear high frequency US probe (Sonosite, Bothell, Washington, USA) was used to localize the tip of the transverse process of the desired vertebra. It was placed in a cephalo-caudal direction, 3 cm from the spinous process. After sterilization, 2-3 ml of 2% lignocaine were injected into the skin and subcutaneous layer. After fixing the transducer on the desired transverse process, we introduced a 22-gauge, 90-mm needle (Spinocan, B. Braun, Germany) in-plane to the US beam in a cephalo-caudal orientation to reach the transverse process. Then we aspirated to rule out accidental vascular puncture and injected 1-2 ml of normal saline to verify proper needle tip positioning. A fluid line was seen spreading below the erector spinae muscle, splitting it from the transverse process. A 20-ml bolus of plain bupivacaine 0.25% was administered.
Spinal intradural arachnoid cyst as a complication of insertion of an interspinous device
Published in British Journal of Neurosurgery, 2023
Han Gyu Lee, Moo Sung Kang, Young Chul Na, Byung Ho Jin
ISDs limit spine extension and avoid narrowing of the neural foramen in patients with spinal stenosis.21 The devices have been widely used since they can circumvent the need for laminectomy; however, recent studies have questioned their efficacy and safety. The overall hardware-related complication rate is in the range of 3.3–38%.22–26 The most common complication is symptomatic spinous process fracture, primarily attributed to over-distraction on an osteoporotic spine, which occurs with a frequency of 2.4-rela21,27,28 Prosthesis loosening or dislocation has also been reported with a high frequency.6 In addition to anterior displacement or spinous process fracture, device failure remains a challenging matter, with an incidence of 2.8, which6,29 Tamburrelli et al. analyzed a series of 19 patients with residual pain by 2 years after ISD insertion and reported two cases of device breakage.29 In this case, the ISD was initially inserted at the site of laminectomy which is unusual as they are normally used as an alternative to laminectomy. This likely resulted in contact between the implant and duar and we suggest ISDs not be used in this way.
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.