NBAS/RALF deficiency
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop in Atlas of Inherited Metabolic Diseases, 2020
Short stature is one of the most frequent findings in NBAS deficiency (Figure 106.2). The affected Yakuts had a mean SDS of height of -4.44 in females and -3.16 in males [1], in our study population, mean height was -2.64 SDS [3], the most severe case known to us however had a severe growth retardation with -6.10 SDS (despite a genetically determined body height of 0.89 SDS) (Figure 106.3). The severity of growth retardation seems to be associated with further skeletal features, such as thin bones and epiphyseal dysplasia with multiple phalangeal pseudo-epiphyses, reminiscent of a disturbance in bone mineralization. Two patients were found to have small cervical vertebrae (C1, C2) causing cervical instability [8]. Large fontanels with delayed closure, short neck, and abnormal thoracic configuration have also been described. There may be frequent or spontaneous fractures, even from the neonatal age on [5].
Biomechanics of spinal trauma
Youlian Hong, Roger Bartlett in Routledge Handbook of Biomechanics and Human Movement Science, 2008
Vertebrae increase in size inferiorly from cervical to lumbar regions and demonstrate region-dependent anatomical characteristics. Cervical vertebrae, C1 to C7, are the smallest of the spinal column. Lower cervical vertebrae, C3 to C7, demonstrate approximately consistent anatomy. The most distinct feature is its anteriorly-oriented vertebral body. The bodies are oval-shaped in the horizontal plane. The saddle-shape of the bodies in the coronal plane are due to the bilateral uncinate processes. All vertebral bodies consist of trabecular bone and cortical shell. Superior and inferior surfaces have endplates, consisting of a thin shell of horizontally-oriented cortical bone. Postero-laterally oriented pedicles connect the vertebral body to the articular pillars, known as lateral masses. The two articular pillars are the second most massive portions of the vertebrae. Superior and inferior surfaces are flat and oriented at approximately 45° in the sagittal plane. Postero-medially oriented laminae connect the pillars to the spinous process. The posterior edge of the vertebral body, pedicles, pillars, and laminae enclose the vertebral foramen, through which the spinal cord traverses. Spinous processes extend posteriorly and are approximately one-half of the anterior-posterior vertebral length. The posterior-most extent of spinous processes C3 to C6 bifurcates into two tubercles. C7 spinous process does not bifurcate and is more prominent than other vertebrae, a feature evident on lateral x-rays.
The Governor Vessel (GV)
Narda G. Robinson in Interactive Medical Acupuncture Anatomy, 2016
Tendon of the trapezius muscle: The trapezius originates from 1) the external occipital protuberance and superior nuchal line of the occipital bone, 2) the ligamentum nuchae, 3) the spinous process of the seventh cervical vertebra and the spinous processes of all thoracic vertebrae, and 4) the corresponding portions of the supraspinous ligament. The superior fibers insert onto the posterior aspect of the lateral clavicle; the middle fibers insert onto the acromion and the spine of the scapula; the inferior fibers converge near the scapula to end in an aponeurosis, which inserts onto a tubercle at the medial end of the spine of the scapula. The superior fibers elevate the scapula, the middle fibers retract it, and the inferior fibers depress the scapula.
Ultrasound guided erector spinae plane block versus quadratus lumborum block for postoperative analgesia in patient undergoing open nephrectomy: A randomized controlled study
Published in Egyptian Journal of Anaesthesia, 2021
Shereen E. Abd Ellatif, Sara M. Abdelnaby
The patient was placed in the lateral decubitus position according to the selected site of surgical intervention. After sterilization and drapping of the skin of the upper back, counting down from seventh cervical vertebrae spine to identify the spine of the seventh thoracic vertebrae (T7). This was related to the tip of the scapular spine. A high-frequency probe of Sonosite M Turbo ultrasonography (FUJIFILM sonosite, Inc., Bothell, WA, USA) was placed across the T7 spine and the probe was moved laterally to identify the transverse process of T7. Thereafter, the probe was moved to a sagittal plane to visualize the erector spinae muscles lying underneath the trapezius muscle. A 22-gauge, 80 mm needle (Stimuplex D, B-Braun, Germany) was inserted medially in-plane relative to the ultrasound probe and directed towards the transverse process. Once the needle was underneath the anterior fascia of the erector spinae muscle (Figure 2), 1 ml normal saline was injected for hydro-dissection sign to verify the needle tip, and then a volume of 0.3–0.4 ml/kg 0.25% bupivacaine with a maximum volume of 30 ml was injected under the erector spinae muscle into the newly formed space [19].
A multi-body model for comparative study of cervical traction simulation – comparison between inclined and sitting traction
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
Lawrence K. F. Wong, Zhiwei Luo, Nobuyuki Kurusu, Keiji Fujino
Eight rigid bodies are used to represent the head and the seven pieces of the cervical vertebrae (C1–C7) in the cervical spine. Each intervertebral joint is modelled as non-linear viscoelastic material in the flexion/extension direction and with linear spring-damper in the tension/compression direction and anterior/posterior shear direction. Figure 2 illustrates structure of the intervertebral joint that represents the tension/compression, flexion/extension and posterior ligament. The biomechanical parameters, including stiffness, damping, ROM, are referenced from published head-neck simulation model studies (de Jager 1996; Yoganandan et al. 2000; van Lopik and Acar 2007) and cadaver sample studies (Moroney et al. 1988; Yoganandan et al. 1996). The simulation model is developed using C++ in Microsoft Visual Studio 2015 using the Bullet physics library as the physics engine. The timestep is fixed at 1/360th second (∼2.78ms). Traction force is applied incrementally within a period of 10 seconds and remains constant until the end of the trial. The period of each simulation trial is 15 seconds. Details regarding the development and validation of the simulation model can be found in the first part of the study (Wong, Luo, Kurusu, et al. 2019).
Analysis of stress and stabilization in adolescent with osteoporotic idiopathic scoliosis: finite element method
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Qiaolin Zhang, Yan Zhang, Teo. Ee Chon, Julien S. Baker, Yaodong Gu
The images were segmented using Mimics 20.0 (Materialise, Leuven, Belgium) to obtain the boundaries of the skeleton. The uneven surfaces caused by stacking of the medical images were processed using Geomagic Studio (2013) (Geomagic, Inc., Research Triangle Park, NC, United States). Each surface component was then imported into Solidworks 2020 (SolidWorks Corporation, MA, United States) individually to form solid parts. The annulus fibrosis, nucleus pulposus, endplate, and articular cartilage were established in Solidworks 2020 according to the anatomical characteristics of the lumbar spine. The thickness of the cortical bone of the vertebral body ranges from 0.18 mm to 0.6 mm (Ritzel et al. 1997). The average thickness of cortical bone is about 0.2 mm. The width of the lumbar vertebrae is larger than that of the thoracic or cervical vertebrae. The thickness of cortical bone does not depend on individual sex but decreases with age. In this study, the thickness of cortical bone is 0.4 mm and the thickness of endplate is 0.5 mm (Gómez et al. 2017).
Related Knowledge Centers
- Cervical Rib
- Lumbar Vertebrae
- Skull
- Thoracic Vertebrae
- Vertebra
- Vertebral Vein
- Vertebral Artery
- Neck
- Inferior Cervical Ganglion
- Vertebral Foramen