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Evaluation of the Spine in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Ashish Dagar, Sarvdeep Singh Dhatt, Deepak Neradi, Vijay G Goni
Normal curvature of the dorsal spine is that of kyphosis of around 40°. An abnormal increase over the normal value of kyphosis, either segmental or global, constitutes deformity. A knuckle is kyphosis caused by the involvement of a single vertebra appreciated as prominence of one spinous process on palpation. A knuckle can easily be missed on inspection or can present as a subtle loss of central furrow on inspection. Angular kyphosis is the involvement of two or three vertebrae. Round kyphosis is the involvement of more than three vertebrae. Round kyphosis can be postural or pathological, such as Scheuermann’s kyphosis (Figure 12.14). To differentiate between the two, ask the patient to bend forward, keeping the knees in neutral position. If deformity disappears or reduces, it is postural. However, if the deformity becomes more prominent, it is Scheuermann’s kyphosis. Flexibility of the curve can be assessed by making the patient do an extension of the spine in prone position. If deformity reduces with extension, a curve is flexible.
Anaesthetic Management of Early-Onset Scoliosis
Published in Alaaeldin (Alaa) Azmi Ahmad, Aakash Agarwal, Early-Onset Scoliosis, 2021
Damarla Haritha, Souvik Maitra
Scoliosis is the lateral and rotational deformity of the vertebral bodies, which causes the shift of the spines of vertebrae toward the concave side [1]. The bending of vertebral bodies toward one side leads to posterior shift of the ribcage on the convex side, forming a hump that deforms the chest wall. Moreover, there can be crowding of the ribs on the concave side and widening of the ribs on the convex side. With an overall incidence of 2%–3% in the general population, scoliosis poses a challenge to the anaesthesiologist as this chest wall deformity has serious consequences on the cardiorespiratory status of the patient [2].
Low Back Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
The spine is a column of 33 vertebrae. Five of the lower vertebrae are fused into the sacrum. The coccyx is formed from three to five (most often four) rudimentary vertebrae and does not contain a spinal canal, pedicles, laminae, or spinous processes.47 The rest of the vertebrae are connected by facet joints. Tucked between the vertebrae are cushion-like pads called discs, whose function is to protect the spine and provide flexibility. Resting within the column of vertebrae lies the spinal cord, and the nerve roots are outside the special column.
Findings in ancient Egyptian mummies from tomb KV64, Valley of the Kings, Luxor, with evidence of a rheumatic disease
Published in Scandinavian Journal of Rheumatology, 2023
LM Öhrström, R Seiler, S Bickel, F Rühli
The cervical vertebrae C1–C6 (which are skeletonized and each individually separated from the rest of the vertebral column) show pathological changes, notably osteophyte formation. In particular, the dens axis is strongly affected, as well as vertebrae C4 and C5, which show considerable osteophyte formation at the anterior and posterior vertebral body (Figure 4). The spinous process of vertebra C3 is (post-mortem) fractured; the distal end is missing. The rest of the vertebral column from C7 downwards is intact and found in the anatomical position. However, the spine is malpositioned, showing a hyperkyphosis of the thoracic spine and a thoracoabdominal scoliotic deformation, which is probably due to post-mortem positioning. On the lateral radiographs, the vertebral alignment of the thoracic and lumbar spine appears to be intact, and no obvious height reduction of the vertebrae or substantial osteophytic formation is observed. On the anteroposterior projections, on the other hand, a pointed osteophytic outgrowth can be assumed at the endplate of the lumbar vertebra L2 on the right side. No obviously pathological calcifications in the surrounding soft tissues are observed. However, C7 and the proximal part of the thoracic spine are difficult to interpret in the lateral projections owing to superimposition of other anatomical structures.
Effects of backrest and seat-pan inclination of tractor seat on biomechanical characteristics of lumbar, abdomen, leg and spine
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Qichao Wang, Yihuan Huo, Zheng Xu, Wenjie Zhang, Yujun Shang, Hongmei Xu
The spine plays various roles in supporting the trunk, protecting the internal organs, controlling human movement and protecting the spinal cord. The adult spine consists of 26 vertebrae, including seven cervical vertebrae (C1–C7), 12 thoracic vertebrae (T1–T12), five lumbar vertebrae (L1–L5), one sacral vertebra and one caudal vertebra from the top to the bottom. The load of spine in different parts is the sum of the weight of the above limbs, muscle tension and external load. Therefore, the spine gradually widens from the top to the bottom, which is in line with the gradual increase in spinal load. The thoracic vertebra is the most important part of human spine, playing important roles in maintaining the stability and driving the movement of human upper limbs. The lumbar spine is located at the bottom of the spine, acting as a junction of the movable segment and the fixed segment. It bears a large load and is the most frequent site for the occurrence of lumbar occupational diseases. Based on these facts, this study selected some thoracic segments and the whole lumbar segment as the objects for analysis.
Biomechanical modeling of spinal ligaments: finite element analysis of L4-L5 spinal segment
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Shabnam Hamidrad, Masoud Abdollahi, Vahid Badali, Mohammad Nikkhoo, Sadegh Naserkhaki
Generally, spine models include three components: vertebra, intervertebral disc, and ligaments. There is a great deal of studies on detailed modeling of the vertebra and disc under various conditions (Fagan et al. 2002; Cheung et al. 2003; Crawford et al. 2003a; Crawford et al. 2003b; Li and Wang 2006; Mirzaei et al. 2009; Nikkhoo et al. 2013; Nikkhoo et al. 2018). However, effects of ligaments modeling on the spine biomechanical results rarely have been investigated in the literature. FE modelling of spine, as a complex mechanical part of body, has been subjected to several assumptions in order to simplify the models (Jones and Wilcox 2008). Consequently, the results of FE analyses on the spine or spinal segments have depended on how these assumptions represent the actual characteristics of different spinal parts (Sharma et al. 1998). For example, spinal ligaments have been commonly simplified as unidirectional (1 D) element (e.g., spring or truss element) in FE modeling of spine, since it was believed that they had reaction along one direction and the collagen fibers were adopted in one (load) direction only (Cheung et al. 2003; Noailly et al. 2005; Little et al. 2008; Ayturk and Puttlitz 2011; Little and Adam 2015; Naserkhaki et al. 2018; Damm et al. 2020). This is while, 1 D elements in FE models were unable of showing stress/strain distribution and/or concentrations to analyze the ligament failure/tear in detail. Therefore, the effect of this assumption on the results of the 3 D complex FE analysis yet to be investigated.