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Anatomy of the Anterior Abdominal Wall
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
The central part of the posterior abdominal wall is formed by the lumbar spine and laterally the psoas muscles. The muscles lie on either side of the vertebral bodies anterior to the transverse processes. Lateral to the tips of the transverse processes, the quadratus lumborum runs vertically with its origin on the iliolumbar ligament and along the posterior iliac crest. It is inserted on the undersurface of the 12th rib superficial to the neurovascular bundle. Its medial ‘free’ edge is bound to the transverse processes of the lumbar vertebra with its investing layer of fascia. The lateral free edge lies superficial to the posterior part of the transversus abdominis.
Animal Models of Scoliosis
Published in Yuehuei H. An, Richard J. Friedman, Animal Models in Orthopaedic Research, 2020
Noriaki Kawakami, Masao Deguchi, Tokumi Kanemura
As already described, rib cage deformity or rib resection was reported to disturb the balance of the spine and caused spinal deformity. A morphometric and morphological study on the thoracic cage indicated ribs played some role of transmission of considerable load from the sternum to the spinal column. The transverse processes and ligaments around them were important structures as load transmitters between ribs and the spinal column. Langenskiold and Michel sson34 paid attention to the importance of costo-transverse ligaments and succeeded in producing scoliosis by section of anterior and posterior costo-transverse ligaments at four or five levels in rabbits and pigs. However, severe progressive scoliosis was only seen in a few of 47 rabbits. They speculated this was because scar formation around the incised ligaments might have prevented the progression of scoliosis. The same procedures in pigs revealed a scoliosis of 30-45 degrees with the rate of occurrence at 90%. They concluded that posterior costo-transverse ligament was of decisive importance in its equilibrium and symmetrical growth by transmitting the effect of the normal muscle tone to the spine. Karaharju35 also severed dorsal ligaments of the 8th to 12th ribs in three pigs and produced scoliosis of 12-35 degrees.
Death Along the Tracks: The Role of Forensic Anthropology and Social Media in a Homicide Investigation
Published in Heather M. Garvin, Natalie R. Langley, Case Studies in Forensic Anthropology, 2019
Perimortem fractures were identified on three lumbar vertebrae (L1–L3). All three vertebrae showed complete fractures through the left transverse processes, consistent with one or more blunt force impacts to the left side of the body (see Figure 1.6). Fractures of the transverse processes are common and often result from direct blows to the lower back and from motor vehicle accidents (Galloway, 1999). One retrospective clinical study found that nearly half of the patients who presented with transverse process fractures of lumbar vertebrae had a significantly higher chance of abdominal organ injuries than patients who presented with fractures to the vertebral body, pedicle, or spinous process (Miller et al., 2000). These findings suggest that transverse process fractures to the lumbar spine may be more serious than previously recognized in the clinical literature.
Erector spinae plane block versus thoracic paravertebral block for pain management after total bilateral mastectomies
Published in Baylor University Medical Center Proceedings, 2021
Jesse W. Stewart, Jenny Ringqvist, Rachel D. Wooldridge, Deborah E. Farr, Mary Sunna, Cedar Schulz, John C. Alexander, Abu Minhajuddin, Irina Gasanova, Girish P. Joshi
With the patient in sitting position and following aseptic preparation of both injection sites, the ultrasound transducer was placed in a parasagittal orientation approximately 2 to 3 cm lateral to the spinous processes. Using external landmarks and real-time ultrasound imaging, the T4 transverse process was identified. For the ESPB, a 21-gauge 100 mm insulated needle (Pajunk, Germany) was introduced cephalad to caudad in plane to the ultrasound beam through the paraspinous muscles until reaching the T4 transverse process. With the needle tip visualized under the erector spinae muscles and on top of the T4 transverse process, 20 mL of the local anesthetic ropivacaine 0.5% was slowly and incrementally injected with frequent aspiration, raising the erector spinae muscle fascia off the transverse process. Spread of local anesthetic in the erector spinae plane was observed in real time via ultrasound guidance.
Ultrasound guided paravertebral block versus intravenous lidocaine infusion for management of post-thoracotomy pain
Published in Egyptian Journal of Anaesthesia, 2021
Tamer Fayez Safan, Wael Ahmed Ibrahim, Mohamed Ibrahim Belita, Ahmed Abdalla Mohamed, Ahmed Essam Salem
However, locating the thoracic paravertebral space (TPVS) can be technically difficult because it requires location of the transverse process and blind needle placement gives a failure rate of 6.8–10%. Also, failure to identify the transverse process results in several needle reorientations causing pain and increases the potential risk of complications. On contrary, the use of ultrasound offers several advantages including visualizing boundaries of the TPVS and sometimes its structures, the capability to visualize the needle, the spread of local anesthetic solution and the placement of a catheter in the PVS under direct vision, thus allowing depositing the local anesthetic solution and placing the catheter tip between the superior costo-transverse ligament and the parietal pleura [8,9].
Surgical management of spine injuries in severe polytrauma patients: a retrospective study
Published in British Journal of Neurosurgery, 2020
C. Joubert, P.-J. Cungi, P. Esnault, A. Sellier, H. de Lesquen, J.-P. Avaro, J. Bordes, A. Dagain
Details of 143 spinal injuries in the 83 patients who fulfilled the inclusion criteria are presented in Table 2. The spinal injuries were unifocal in 50.6% (n = 42) of patients, bifocal in 31.3% (n = 26) and multifocal in 18.1% (n = 15). Isolated transverse processes or spinous process fractures defined as ‘minor’ were observed in 22 cases (15.4%). Interestingly, regardless of spinal injury severity, a statistically significant difference was found according to ISS average (p = .01; 95% CI, 42.39–57.61) between patients with multiple spinal lesions (average = 41, SD = 14.51) and patients with a single spinal lesion (average = 32, SD = 13.6). In fact, we observed significant correlation between the number of spinal injuries and the ISS to the calculation: to calculate an ISS, we had to take the highest AIS severity code in each of the three most severely injured ISS body regions, then we had to square each AIS code and finally we had to add the three squared numbers for an ISS (ISS=A2 + B2 + C2 where A, B, and C are the AIS scores of the three most injured ISS body regions).