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1.
Acta Med Okayama ; 78(3): 251-258, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38902213

ABSTRACT

There have been few investigations into the effectiveness of thoracic spine exercises for improving thoracic range of motion (ROM) in any plane. This study assessed the effectiveness of two thoracic spine exercises: one in the quadruped position and one in the thoracic standing position. We determined how these exercises affect thoracic spine mobility ROM over a 2-week intervention period. Thirty-nine healthy participants were enrolled and assigned to a Quadruped Thoracic Rotation group (n=17 participants: 9 females and 8 males) or Flamenco Thoracic Spine Rotation group (n=22: 14 females and 8 males). All participants were administered a KOJI AWARENESSTM screening test, and the initial thoracic spine ROM before intervention exercise was measured in a laboratory setting. Quadruped Thoracic Rotation was performed as the quadruped exercise and Flamenco Thoracic Spine Rotation as the standing exercise. The KOJI AWARENESSTM thoracic spine test and ROM were evaluated on the day after the first exercise session and again after the program. Despite their different approaches to thoracic mobility, the quadruped exercise and standing exercise achieved equivalent improvement in thoracic ROM after 2 weeks. Practitioners have a range of exercise options for enhancing thoracic mobility based on their environmental or task-specific needs.


Subject(s)
Exercise Therapy , Range of Motion, Articular , Thoracic Vertebrae , Humans , Male , Female , Adult , Thoracic Vertebrae/physiology , Rotation , Young Adult , Exercise Therapy/methods
2.
Proc Natl Acad Sci U S A ; 116(49): 24457-24462, 2019 12 03.
Article in English | MEDLINE | ID: mdl-31740616

ABSTRACT

Microarchitectured materials achieve superior mechanical properties through geometry rather than composition. Although ultralightweight microarchitectured materials can have high stiffness and strength, application to durable devices will require sufficient service life under cyclic loading. Naturally occurring materials provide useful models for high-performance materials. Here, we show that in cancellous bone, a naturally occurring lightweight microarchitectured material, resistance to fatigue failure is sensitive to a microarchitectural trait that has negligible effects on stiffness and strength-the proportion of material oriented transverse to applied loads. Using models generated with additive manufacturing, we show that small increases in the thickness of elements oriented transverse to loading can increase fatigue life by 10 to 100 times, far exceeding what is expected from the associated change in density. Transversely oriented struts enhance resistance to fatigue by acting as sacrificial elements. We show that this mechanism is also present in synthetic microlattice structures, where fatigue life can be altered by 5 to 9 times with only negligible changes in density and stiffness. The effects of microstructure on fatigue life in cancellous bone and lattice structures are described empirically by normalizing stress in traditional stress vs. life (S-N) curves by √ψ, where ψ is the proportion of material oriented transverse to load. The mechanical performance of cancellous bone and microarchitectured materials is enhanced by aligning structural elements with expected loading; our findings demonstrate that this strategy comes at the cost of reduced fatigue life, with consequences to the use of microarchitectured materials in durable devices and to human health in the context of osteoporosis.


Subject(s)
Biomimetic Materials/chemistry , Fatigue , Thoracic Vertebrae/chemistry , Thoracic Vertebrae/physiology , Aged , Aged, 80 and over , Biomechanical Phenomena , Compressive Strength , Elastic Modulus , Female , Finite Element Analysis , Humans , Male , Methacrylates , Middle Aged , Models, Theoretical , Polyurethanes , Porosity , Tensile Strength , Thoracic Vertebrae/diagnostic imaging , Weight-Bearing , X-Ray Microtomography
3.
PLoS Biol ; 16(7): e2005460, 2018 07.
Article in English | MEDLINE | ID: mdl-29985914

ABSTRACT

Here, we investigated intrinsic spinal cord mechanisms underlying the physiological requirement for autonomic and somatic motor system coupling. Using an in vitro spinal cord preparation from newborn rat, we demonstrate that the specific activation of muscarinic cholinergic receptors (mAchRs) (with oxotremorine) triggers a slow burst rhythm in thoracic spinal segments, thereby revealing a rhythmogenic capability in this cord region. Whereas axial motoneurons (MNs) were rhythmically activated during both locomotor activity and oxotremorine-induced bursting, intermediolateral sympathetic preganglionic neurons (IML SPNs) exhibited rhythmicity solely in the presence of oxotremorine. This somato-sympathetic synaptic drive shared by MNs and IML SPNs could both merge with and modulate the locomotor synaptic drive produced by the lumbar motor networks. This study thus sheds new light on the coupling between somatic and sympathetic systems and suggests that an intraspinal network that may be conditionally activated under propriospinal cholinergic control constitutes at least part of the synchronizing mechanism.


Subject(s)
Acetylcholine/pharmacology , Motor Activity/drug effects , Periodicity , Spinal Cord/physiology , Sympathetic Nervous System/physiology , Animals , Animals, Newborn , Cholinesterase Inhibitors/pharmacology , Glutamates/metabolism , Interneurons/drug effects , Interneurons/physiology , Lumbar Vertebrae/drug effects , Lumbar Vertebrae/physiology , Motor Neurons/drug effects , Motor Neurons/physiology , Muscarinic Antagonists/pharmacology , N-Methylaspartate/pharmacology , Nerve Net/drug effects , Nerve Net/physiology , Oxotremorine/pharmacology , Rats, Sprague-Dawley , Receptors, Muscarinic/metabolism , Serotonin/pharmacology , Spinal Cord/drug effects , Sympathetic Nervous System/drug effects , Thoracic Vertebrae/drug effects , Thoracic Vertebrae/physiology
4.
Clin J Sport Med ; 31(2): e86-e94, 2021 Mar 01.
Article in English | MEDLINE | ID: mdl-30439725

ABSTRACT

OBJECTIVE: To assess the role of exercise targeting proper trunk stabilization and segmental spinal movement in back pain and sensory perception among cross-country skiers. DESIGN: Randomized, controlled trial with blinded outcome assessors. SETTING: University Hospital, Department of Rehabilitation and Sports Medicine. PARTICIPANTS: Twenty elite cross-country skiers aged 17 to 27 years. INTERVENTIONS: Ten cross-country skiers integrated 3 types of exercise targeting segmental motion in mid-thoracic spine into their routine training practice for 2 months. The 10 controls performed routine athletic training. MAIN OUTCOME MEASURES: The Young Spine Questionnaire to measure intensity and frequency of back pain was completed at the start and end of study. Tactile sensory perception using 10-g Semmes-Weinstein monofilament, thermic perception using TIP THERM device, graphesthesia assessed by a touch monitor pencil, 2-point discrimination assessed by a digital caliper, and vibration perception assessed by a 128-Hz tuning fork measured in mid-thoracic spine 5 times. RESULTS: No significant group differences in pain and sensory perception were identified at baseline. Over the 2-month study interval, repeated-measures analysis of variance revealed that the experimental group improved significantly relative to the control group on pain intensity (P = 0.005 for cervical, P = 0.004 for thoracic, and P = 0.014 for lumbar) and frequency of pain in the thoracic area only (P = 0.011). Improvements were also observed in the experimental relative to control group on graphesthesia (P < 0.001), vibration perception (P = 0.002), and 2-point discrimination (P < 0.001). CONCLUSIONS: Exercise targeting the mid-thoracic spine may decrease back pain and improve sensory perception in cross-country skiers. LEVEL OF EVIDENCE: Original research, level I.


Subject(s)
Back Pain/prevention & control , Physical Conditioning, Human/methods , Skiing/injuries , Thoracic Vertebrae/physiology , Touch Perception/physiology , Adolescent , Adult , Back Pain/physiopathology , Humans , Male , Movement , Pain Perception/physiology , Skiing/physiology , Young Adult
5.
Eur Spine J ; 29(1): 179-185, 2020 01.
Article in English | MEDLINE | ID: mdl-31664565

ABSTRACT

PURPOSE: The aim of this study was to quantify the stabilizing effect of the passive structures in thoracic spinal motion segments by stepwise resections. These data can be used to calibrate finite element models of the thoracic spine, which are needed to explore novel surgical treatments of spinal deformities, fractures, and tumours. METHOD: Six human thoracic spinal motion segments from three segmental levels (T2-T3, T6-T7, and T10-T11) were loaded with pure moments of 1 and 2.5 Nm in flexion/extension, lateral bending, and axial rotation. After each loading step, the ligaments, facet capsules, and the nucleus pulposus were stepwise resected from posterior to anterior direction, while the segmental relative motions were measured using an optical motion tracking system. RESULTS: Significant increases (p < 0.05) in the range of motion were detected after resecting the anterior spinal structures depending on loading magnitude, motion direction, and segmental level. The highest relative increases in the range of motion were observed after nucleotomy in all motion directions. The vertebral arch mostly stabilized the thoracic spinal motion segments in flexion and extension, while the facet joint capsules mainly affected the segmental stability in axial rotation. Coupled motions were not observed. CONCLUSIONS: The anulus fibrosus defines the motion characteristics qualitatively, while the ligaments and the presence of the nucleus pulposus restrict the mobility of a thoracic spinal motion segment solely in a quantitative manner. The posterior ligaments do not predominantly serve for primary stability but for the prevention of hyperflexion. These slides can be retrieved under Electronic Supplementary Material.


Subject(s)
Intervertebral Disc/physiology , Ligaments, Articular/physiology , Range of Motion, Articular/physiology , Thoracic Vertebrae/physiology , Humans , Intervertebral Disc/surgery , Ligaments, Articular/surgery , Rotation , Thoracic Vertebrae/surgery , Zygapophyseal Joint/physiology , Zygapophyseal Joint/surgery
6.
J Sports Sci ; 38(10): 1085-1095, 2020 May.
Article in English | MEDLINE | ID: mdl-32281483

ABSTRACT

Fast bowling is categorised into four action types: side-on, front-on, semi-open and mixed; however, little biomechanical comparison exists between action types in junior fast bowlers. This study investigated whether there are significant differences between action-type mechanics in junior fast bowlers. Three-dimensional kinematic and kinetic analyses were completed on 60 junior male fast bowlers bowling a five-over spell. Mixed-design factorial analyses of variance were used to test for differences between action-type groups across the phases of the bowling action. One kinetic difference was observed between groups, with a higher vertical ground reaction force loading rate during the front-foot contact phase in mixed and front-on compared to semi-open bowlers; no other significant group differences in joint loading occurred. Significant kinematic differences were observed between the front-on, semi-open and mixed action types during the front-foot contact phase for the elbow and trunk. Significant kinematic differences were also present for the ankle, T12-L1, elbow, trunk and pelvis during the back-foot phase. Overall, most differences in action types for junior fast bowlers occurred during the back-foot contact phase, particularly trunk rotation and T12-L1 joint angles/ranges of motion, where after similar movement patterns were utilized across groups during the front-foot contact phase.


Subject(s)
Sports/classification , Sports/physiology , Adolescent , Biomechanical Phenomena , Humans , Lower Extremity/physiology , Lumbar Vertebrae/physiology , Male , Pelvis/physiology , Range of Motion, Articular , Thoracic Vertebrae/physiology , Time and Motion Studies , Torso/physiology , Upper Extremity/physiology
7.
World J Surg ; 43(3): 920-928, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30465085

ABSTRACT

BACKGROUND: We have reported the impact of sarcopenia and body composition on patients undergoing hepatectomy for hepatocellular carcinoma (HCC). However, the impact of bone mineral density (BMD) on outcomes after hepatectomy for HCC and correlation with other parameters including sarcopenia are unclear. METHODS: We retrospectively analyzed 465 patients who underwent primary hepatectomy for HCC between April 2005 and March 2015. We analyzed the plain CT images at the level of the eleventh thoracic vertebra with the region of interest and defined as preoperative BMD. RESULTS: In this cohort, male (n = 367) and female (n = 98) patients showed significant heterogeneity in age, body composition markers, tumor factors, peri-operative parameters and so on. The median preoperative BMD in male and female patients was 155 and 139 HU, respectively (P = 0.005). BMD was negatively correlated with age in female (r = -0.590, P < 0.001) and intramuscular adipose tissue content in both male and female (r = -0.332 and -0.359, respectively, P < 0.001). For males, BMD < 160 HU was associated with worse cancer-specific survival post-hepatectomy (P = 0.015). In contrast, females were not (P = 0.135). For male patients, multivariate analysis identified low BMD as an independent risk factor for death (hazard ratio 1.720, 95% confidence interval 1.038-2.922, P = 0.035) after hepatectomy for HCC. CONCLUSION: Preoperative low BMD was an independent risk factor for cancer-specific mortality after hepatectomy for HCC.


Subject(s)
Bone Density/physiology , Carcinoma, Hepatocellular , Hepatectomy/statistics & numerical data , Hospital Mortality , Liver Neoplasms/surgery , Adipose Tissue/physiology , Aged , Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/surgery , Female , Hepatectomy/methods , Humans , Male , Middle Aged , Multivariate Analysis , Outcome Assessment, Health Care , Proportional Hazards Models , Retrospective Studies , Risk Factors , Thoracic Vertebrae/physiology
8.
J Anat ; 233(1): 55-63, 2018 07.
Article in English | MEDLINE | ID: mdl-29708263

ABSTRACT

The epaxial muscles produce intervertebral rotation in the transverse, vertical and axial axes. These muscles also counteract the movements induced by gravitational and inertial forces and movements produced by antagonistic muscles and the intrinsic muscles of the pelvic limb. Their fascicles are innervated by the dorsal branch of the spinal nerve, which corresponds to the metamere of its cranial insertion in the spinous process. The structure allows the function of the muscles to be predicted: those with long and parallel fibres have a shortening function, whereas the muscles with short and oblique fibres have an antigravity action. In the horse, the multifidus muscle of the thoracolumbar region extends in multiple segments of two to eight vertebral motion segments (VMS). Functionally, the multifidus muscle is considered a spine stabiliser, maintaining VMS neutrality during spine rotations. However, there is evidence of the structural and functional heterogeneity of the equine thoracolumbar multifidus muscle, depending on the VMS considered, related to the complex control of the required neuromuscular activity. Osteoarticular lesions of the spine have been directly related to asymmetries of the multifidus muscle. The lateral (LDSM) and medial (MDSM) dorsal sacrocaudal muscles may be included in the multifidus complex, the function of which is also unclear in the lumbosacral region. The functional parameters of maximum force (Fmax ), maximum velocity of contraction (Vmax ) and joint moment (M) of the multifidus muscles inserted in the 4th, 9th, 12th and 17th thoracic and 3rd and 4th lumbar vertebrae of six horses were studied postmortem (for example: 4MT4 indicates the multifidus muscle that crosses four metameres with cranial insertion in the T4 vertebra). Furthermore, the structural and functional characteristics of LDSM and MDSM were determined. Data were analysed by analysis of variance (anova) in a randomised complete block design (P ≤ 0.05). For some muscles, the ordering of Vmax values was almost opposite to that of Fmax values, generally indicating antigravity or dynamic functions, depending on the muscle and VMS. The muscles 3MT12, 3ML3 and 4ML4 exhibited high Fmax and low Vmax values, indicating a stabilising action. The very long 7MT4 and 8MT4 multifidus had low Fmax and high Vmax values, suggesting a shortening action. However, some functional characteristics of interest did not fall within these general observations, also indicating a dual action. In summary, the results of the analysis of various structural and functional parameters confirm the structural and functional heterogeneity of the equine thoracolumbar multifidus complex, depending on the VMS, regardless of the number of metameres crossing each fascicle. To clarify the functions of the equine multifidus muscle complex, this study aimed to assess its functional parameters in thoracolumbar VMSs with different movement characteristics and in the MDSM and LDSM muscles, hypothesising that the functional parameters vary significantly when the VMS is considered.


Subject(s)
Back Muscles/physiology , Lumbar Vertebrae/physiology , Sacrum/physiology , Thoracic Vertebrae/physiology , Animals , Back Muscles/anatomy & histology , Horses , Lumbar Vertebrae/anatomy & histology , Sacrum/anatomy & histology , Thoracic Vertebrae/anatomy & histology
9.
Vet Radiol Ultrasound ; 59(6): 749-757, 2018 Nov.
Article in English | MEDLINE | ID: mdl-30058090

ABSTRACT

During minimally invasive spinal surgery, correct identification of the affected intervertebral disc space is critical. Percutaneous palpation is commonly used, but results may be unreliable. Fluoroscopy is the gold standard but can be cumbersome and exposes operators to ionizing radiation. Spinal ultrasound has been described in veterinary medicine and could be a feasible alternative. This prospective, methods comparison study mimicked a minimally invasive spinal surgery in 10 canine cadavers and compared the accuracy of ultrasound and percutaneous palpation for thoracolumbar intervertebral disc space identification, using fluoroscopy as the reference standard. For each experiment, a disc space was randomly chosen. Identification was then attempted using both percutaneous palpation and ultrasound. For ultrasound, a linear probe was used to guide the operator to the correct location. The time necessary to perform each method was recorded. Accuracies for each method were calculated and statistically compared. Effects of body condition score, location of the targeted thoracolumbar intervertebral disc space and learning curve for each method were also evaluated. Ultrasonographic identification was more accurate (96.7% vs. 76.7%; P < 0.03) but took longer (147 s vs. 29 s; P < 0.0001) than percutaneous palpation. Findings from this cadaver study indicated that percutaneous palpation alone had low accuracy for correctly identifying a targeted thoracolumbar intervertebral disc space and supported the use of ultrasound as a method for improving the accuracy. Future studies are needed to assess the method in clinical cases, especially in obese dogs and/or those in which the targeted site is distant from palpable anatomical landmarks.


Subject(s)
Dogs/anatomy & histology , Intervertebral Disc/diagnostic imaging , Lumbar Vertebrae/physiology , Palpation/veterinary , Thoracic Vertebrae/physiology , Ultrasonography/veterinary , Animals , Cadaver , Female , Lumbar Vertebrae/diagnostic imaging , Male , Palpation/methods , Prospective Studies , Thoracic Vertebrae/diagnostic imaging , Ultrasonography/methods
10.
J Manipulative Physiol Ther ; 41(7): 589-595, 2018 09.
Article in English | MEDLINE | ID: mdl-30442357

ABSTRACT

OBJECTIVES: The purpose of this study was to evaluate the immediate effect of thoracic spine manipulation upon active flexion and abduction mobility of the shoulder, spine temperature, and the size of the subacromial space as measured by ultrasound in 3 positions (internal, neutral, and external rotation) of the glenohumeral joint in patients who have undergone surgery because of subacromial impingement. METHODS: Quasi-experimental, prospective, short-term effect study with consecutively sampled participants. Thirty-two patients had undergone subacromial decompression together with supraspinatus tendon suture. The following variables were studied: age, sex, dominant shoulder, presurgery evolution time, working status, surface temperature of dorsal segment with limited mobility, premanipulation functional assessment using the Spanish version of the Upper Limb Functional Index Scale, goniometric range of motion measurement at glenohumeral joint before and after manipulation, and ultrasound measurement of subacromial space before and after manipulation. RESULTS: Significant differences and small effect size were found in measurements for flexion and abduction movements after thoracic spine manipulation (P > .001; ES > 0.2) and subacromial space measurements in neutral rotation and external rotation (P > .001), but without clinical relevance effect size (<0.2). CONCLUSIONS: Active shoulder flexion and abduction mobility increase after manipulation of thoracic spine in patients who have undergone surgery for rotator cuff suture. Subacromial space increases significantly with shoulder in neutral and external rotation position after manipulation. No differences were found regarding surface temperature of manipulated area.


Subject(s)
Manipulation, Spinal , Rotator Cuff/surgery , Shoulder Impingement Syndrome/surgery , Shoulder Joint/diagnostic imaging , Shoulder Joint/physiopathology , Thoracic Vertebrae/physiology , Adult , Decompression, Surgical , Female , Humans , Male , Middle Aged , Prospective Studies , Range of Motion, Articular/physiology , Ultrasonography
11.
Eur Spine J ; 26(1): 173-180, 2017 01.
Article in English | MEDLINE | ID: mdl-25091262

ABSTRACT

PURPOSE: The corrective potential of two posterior-only destabilization procedures for scoliosis deformity was quantified under single and multi-planar loading using cadaveric spines. METHODS: Ten full-length human cadaveric thoracic spines were mounted in an 8-df servohydraulic load frame. Cyclic, pure moments were applied in: (1) flexion-extension, (2) lateral bending, (3) axial rotation, (4) flexion-extension with axial rotation, and (5) lateral bending with axial rotation at 0.5°/s, to ±4 Nm. Each specimen was tested intact, and again after nine en bloc bilateral total facetectomies, and one, two, three, and four levels of Ponte osteotomies. Motion was measured throughout loading using optical motion tracking. RESULTS: Under single-plane loading, facetectomies and Ponte osteotomies increased thoracic spine flexibility in all three planes. Compared to total facetectomies, higher per-level increases were seen following Ponte osteotomies, with increases in total range of motion (total ROM) of up to 2.7° in flexion-extension, 1.4° in lateral bending, and 3.1° in axial rotation following each osteotomy. Compared to the facetectomies, four supplemental osteotomies increased total ROM by 23 % in flexion (p < 0.01) and 8 % in axial rotation (p < 0.01). Increases in lateral bending were smaller. Under multi-planar loading, each Ponte osteotomy provided simultaneous increases of up to 1.4°, 1.6°, and 2.2° in flexion-extension, lateral bending, and axial rotation. CONCLUSIONS: Ponte osteotomies provided higher per-level increases in ROM under single-plane loading than total facetectomies alone. Further, Ponte osteotomies provided simultaneous increase in all three planes under multi-planar loading. These results indicated that, to predict the correction potential of a surgical release, multi-planar testing may be necessary.


Subject(s)
Range of Motion, Articular/physiology , Thoracic Vertebrae/physiology , Weight-Bearing/physiology , Cadaver , Humans , Osteotomy/methods , Rotation , Zygapophyseal Joint/surgery
12.
Eur Spine J ; 26(5): 1401-1407, 2017 05.
Article in English | MEDLINE | ID: mdl-27639711

ABSTRACT

PURPOSE: The influence of the anterior rib cage on the stability of the human thoracic spine is not completely known. One of the most common surgical interventions on the anterior rib cage is the longitudinal median sternotomy and its fixation by wire cerclage. Therefore, the purpose of this in vitro study was to examine, if wire cerclage can restore the stability of the human thoracic spine after longitudinal median sternotomy. METHODS: Six fresh frozen human thoracic spine specimens (C7-L1, 56 years in average, range 50-65), including the intact rib cage without intercostal muscles, were tested in a spinal loading simulator and monitored with an optical motion tracking system. While applying 2 Nm pure moment in flexion/extension (FE), lateral bending (LB), and axial rotation (AR), the range of motion (ROM) and neutral zone (NZ) of the functional spinal units of the thoracic spine (T1-T12) were studied (1) in intact condition, (2) after longitudinal median sternotomy, and (3) after sternal closure using wire cerclage. RESULTS: The longitudinal median sternotomy caused a significant increase of the thoracic spine ROM relative to the intact condition (FE: 12° ± 5°, LB: 18° ± 5°, AR: 25° ± 10°) in FE (+12 %) and AR (+22 %). As a result, the sagittal cut faces of the sternum slipped apart visibly. Wire cerclage fixation resulted in a significant decrease of the ROM in AR (-12 %) relative to condition after sternotomy. ROM increased relative to the intact condition, in AR even significantly (+8 %). The NZ showed a proportional behavior compared to the ROM in all loading planes, but it was distinctly higher in FE (72 %) and in LB (82 %) compared to the ROM than in AR (12 %). CONCLUSIONS: In this in vitro study, the longitudinal median sternotomy resulted in a destabilization of the thoracic spine and relative motion of the sternal cut faces, which could be rectified by fixation with wire cerclage. However, the stability of the intact condition could not be reached. Nevertheless, a fixation of the sternum should be considered clinically to avoid instability of the spine and sternal pseudarthrosis.


Subject(s)
Bone Wires , Range of Motion, Articular/physiology , Rib Cage/physiology , Sternum/surgery , Thoracic Vertebrae/physiology , Aged , Biomechanical Phenomena/physiology , Cadaver , Female , Humans , Male , Middle Aged , Sternotomy/adverse effects
13.
Eur Spine J ; 26(Suppl 1): 225-228, 2017 05.
Article in English | MEDLINE | ID: mdl-28361364

ABSTRACT

PURPOSE: The eosinophilic granuloma is a unifocal or multifocal Langerhans cell histiocytosis characterized by an expanding proliferation of Langerhans cells in bones. Skeletal LCH is a rare condition, and vertebral regeneration in cases of vertebral body collapse is even rarer. We report the case of a girl with spontaneous complete healing. METHODS AD RESULTS: A 3-year-old girl was referred for nighttime back pain, with no fever and no neurologic signs. Within a few days, she developed sudden painful restriction of all spine movements. X-ray and computed tomography (CT) of the spine showed reduced T7 vertebral body height (vertebra plana).The patient underwent T7 curettage and the histopathological exam was suggestive of LCH. Two additional skull lesions were found and therefore she underwent chemotherapy. After 7 years of follow-up, total vertebral reconstruction was observed. CONCLUSIONS: Despite the rarity of the condition and despite the rarity of vertebral body lesion resolution, total vertebral body reconstruction was observed over a 7-year period. Long-term follow-up is necessary for a better understanding of the final outcome of patients with EG.


Subject(s)
Eosinophilic Granuloma/surgery , Spinal Diseases/surgery , Thoracic Vertebrae/surgery , Back Pain/etiology , Child, Preschool , Curettage/methods , Eosinophilic Granuloma/complications , Eosinophilic Granuloma/diagnostic imaging , Female , Fractures, Spontaneous/etiology , Humans , Radiography , Regeneration , Spinal Diseases/complications , Spinal Diseases/diagnostic imaging , Spinal Fractures/etiology , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/physiology , Tomography, X-Ray Computed
14.
Skeletal Radiol ; 46(11): 1541-1551, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28780746

ABSTRACT

OBJECTIVES: To develop age-, gender-, and regional-specific normative values for texture analysis (TA) of spinal computed tomography (CT) in subjects with normal bone mineral density (BMD), as defined by dual X-ray absorptiometry (DXA), and to determine age-, gender-, and regional-specific differences. MATERIALS AND METHODS: In this retrospective, IRB-approved study, TA was performed on sagittal CT bone images of the thoracic and lumbar spine using dedicated software (MaZda) in 141 individuals with normal DXA BMD findings. Numbers of female and male subjects were balanced in each of six age decades. Three hundred and five TA features were analyzed in thoracic and lumbar vertebrae using free-hand regions-of-interest. Intraclass correlation (ICC) coefficients were calculated for determining intra- and inter-observer agreement of each feature. Further dimension reduction was performed with correlation analyses. RESULTS: The TA features with an ICC < 0.81 indicating compromised intra- and inter-observer agreement and with Pearson correlation scores r > 0.8 with other features were excluded from further analysis for dimension reduction. From the remaining 31 texture features, a significant correlation with age was found for the features mean (r = -0.489, p < 0.001), variance (r = -0.681, p < 0.001), kurtosis (r = 0.273, p < 0.001), and WavEnLL_s4 (r = 0.273, p < 0.001). Significant differences were found between genders for various higher-level texture features (p < 0.001). Regional differences among the thoracic spine, thoracic-lumbar junction, and lumbar spine were found for most TA features (p < 0.021). CONCLUSION: This study established normative values of TA features on CT images of the spine and showed age-, gender-, and regional-specific differences in individuals with normal BMD as defined by DXA.


Subject(s)
Bone Density/physiology , Lumbar Vertebrae/diagnostic imaging , Thoracic Vertebrae/diagnostic imaging , Tomography, X-Ray Computed/methods , Absorptiometry, Photon , Adult , Aged , Female , Humans , Lumbar Vertebrae/physiology , Male , Middle Aged , Reference Values , Retrospective Studies , Thoracic Vertebrae/physiology
15.
J Sports Sci ; 35(12): 1134-1141, 2017 Jun.
Article in English | MEDLINE | ID: mdl-27458692

ABSTRACT

This study analysed the behaviour of the geometric curvature of the spine during sirshasana. The position of dorsal retroreflective markers was computed via stereophotogrammetric analysis in six males and five females (29.4 ± 8.8 years, 63.0 ± 11.4 kg, 1.66 ± 0.08 m [average ± standard deviation]). The spinal points were projected onto the sagittal and frontal planes of the trunk, a polynomial was fitted to the data and the two-dimensional geometric curvature was quantified. The inferior lumbar lordosis decreased compared to the orthostatic position and gait, which may favour the posterior protrusion of the lumbar spinal nucleus pulposus in people with posterior herniation. The lateral deviation at the middle of the thoracic spine increases during sirshasana, which may reflect increased difficulties for postural control and spinal loads. It could be useful for promoting positive spinal structural and functional chronic adaptations for healthy participants, if the yoga programme is carefully planned and the spinal alignment is carefully monitored during a headstand. However, it may aggravate some spinal diseases, especially scoliosis.


Subject(s)
Lumbar Vertebrae/physiology , Posture/physiology , Thoracic Vertebrae/physiology , Yoga , Female , Gait/physiology , Humans , Image Processing, Computer-Assisted , Lumbar Vertebrae/diagnostic imaging , Male , Photogrammetry , Thoracic Vertebrae/diagnostic imaging
16.
J Manipulative Physiol Ther ; 40(9): 692-699, 2017.
Article in English | MEDLINE | ID: mdl-29229060

ABSTRACT

OBJECTIVE: The purpose of this study was to develop, assess the reliability of, and validate prediction equations that estimate the sagittal curves of the spine from the skin surface. METHODS: Forty digital panoramic radiographs were used to develop the prediction equation, and 59 radiographs were used to assess reliability and validate the equations. For evaluation of the thoracic and lumbar curves, anatomical reference points were marked on the vertebral body, spinous process, and skin surface at the C6, C7, T2, T4, T6, T8, T10, T12, L2, L4, and S2 vertebrae. Three third-degree polynomials were obtained, estimated with the least squares method: inner curves from the centroid of the vertebral bodies and from the apex of the spinous processes and external curve from the skin surface. The magnitude of the curves of each region was estimated based on the angle between tangent lines at several vertebral levels. Prediction equations were obtained (simple linear regression) for the vertebral levels that had the best correlation between the inner and surface curves. The validation of the prediction equations was confirmed using Pearson's correlation (r), Student t test, and root mean square error. The reliability of the method was confirmed using the intraclass correlation coefficient, standard error of measurement, and minimal detectable change (α = 0.05). RESULTS: The best correlations were obtained between the T4-T12 (thoracic) and T10-S2 (lumbar) levels (r > 0.85). For the intrarater and interrater reliability, the correlation was higher than 0.965 and higher than 0.896, respectively. There was a significant and strong correlation between estimated and actual values for the thoracic and lumbar curves, which was confirmed by the t-test results and by the root mean square error inferior to 1°. CONCLUSION: Prediction equations can precisely and accurately estimate the angles of the internal sagittal curves of the spine from the skin surface.


Subject(s)
Posture/physiology , Radiography, Panoramic/methods , Spinal Curvatures/diagnostic imaging , Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/physiology , Female , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/physiology , Male , Predictive Value of Tests , Reproducibility of Results , Sampling Studies , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/physiology
17.
J Appl Biomech ; 33(2): 166-170, 2017 Apr.
Article in English | MEDLINE | ID: mdl-27834549

ABSTRACT

This study examined isometric strength (maximal voluntary contraction [MVC]) and endurance of cervical flexor and extensor muscles in healthy individuals at the craniocervical (CC) and cervicothoracic (CT) axes. MVC and endurance measures (time to task failure in seconds [s]) at 50% MVC were recorded in 4 directions (CC flexion, CC extension, CT flexion, and CT extension) in 20 males and 20 females, and 6 strength and endurance ratios were calculated. The findings showed that the cervical extensor muscles are not only much stronger than the flexors (1.3-2 times greater MVC), but also have greater capacity for endurance (2-2.4 times greater). While males produced significantly greater MVC recordings than females (P < .003), strength ratios (P > .06) and endurance measures (P > .11) were similar. Endurance ratios were also similar except the CT extension to CC flexion ratio, which was significantly larger in females compared with males (P = .03). These findings demonstrate that substantial but normal variation exists in strength and endurance parameters between cervical flexor and extensor muscles. This is informative to clinicians when evaluating the performance of these neck muscles or when deciding on exercise parameters (eg, load, duration) when training their performance.


Subject(s)
Back Muscles/physiology , Muscle Contraction/physiology , Muscle Strength/physiology , Neck Muscles/physiology , Physical Endurance/physiology , Adult , Cervical Vertebrae/physiology , Female , Humans , Reference Values , Reproducibility of Results , Sensitivity and Specificity , Thoracic Vertebrae/physiology
18.
J Appl Biomech ; 33(4): 288-293, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28290751

ABSTRACT

Lower back pain is commonly associated with golfers. The study aimed: to determine whether thoracic- and lumbar-erector-spinae muscle display signs of muscular fatigue after completing a golf practice session, and to examine the effect of the completed practice session on club head speed, ball speed and absolute carry distance performance variables. Fourteen right-handed male golfers participated in the laboratory-based-study. Surface electromyography (EMG) data was collected from the lead and trail sides of the thoracic- and lumbar-erector-spinae muscle. Normalized root mean squared (RMS) EMG activation levels and performance variables for the golf swings were compared before and after the session. Fatigue was assessed using median frequency (MDF) and RMS during the maximum voluntary contraction (MVC) performed before and after the session. No significant differences were observed in RMS thoracic- and lumbar-erector-spinae muscle activation levels during the five phases of the golf swing and performance variables before and after the session (p > .05). Significant changes were displayed in MDF and RMS when comparing the MVC performed before and after the session (p < .05). Fatigue was evident in the trail side of the erector-spinae muscle after the session.


Subject(s)
Golf/physiology , Muscle Fatigue/physiology , Muscle, Skeletal/physiology , Adult , Electromyography , Humans , Lumbar Vertebrae/physiology , Male , Movement/physiology , Muscle Contraction/physiology , Thoracic Vertebrae/physiology
19.
J Exp Biol ; 219(Pt 19): 2991-3002, 2016 10 01.
Article in English | MEDLINE | ID: mdl-27473436

ABSTRACT

The vertebral column has evolved to accommodate the broad range of locomotor pressures found across vertebrate lineages. Xenarthran (armadillos, sloths and anteaters) vertebral columns are characterized by xenarthrous articulations, novel intervertebral articulations located in the posterior trunk that are hypothesized to stiffen the vertebral column to facilitate digging. To determine the degree to which xenarthrous articulations impact vertebral movement, we passively measured compliance and range of motion during ventroflexion, dorsiflexion and lateral bending across the thoracolumbar region of the nine-banded armadillo, Dasypus novemcinctus Patterns of bending were compared with changes in vertebral morphology along the column to determine which morphological features best predict intervertebral joint mechanics. We found that compliance was lower in post-diaphragmatic, xenarthrous vertebrae relative to pre-xenarthrous vertebrae in both sagittal and lateral planes of bending. However, we also found that range of motion was higher in this region. These changes in mechanics are correlated with the transition from pre-xenarthrous to xenarthrous vertebrae, as well as with the transition from thoracic to lumbar vertebrae. Our results thus substantiate the hypothesis that xenarthrous articulations stiffen the vertebral column. Additionally, our data suggest that xenarthrous articulations, and their associated enlarged metapophyses, also act to increase the range of motion of the post-diaphragmatic region. We propose that xenarthrous articulations perform the dual role of stiffening the vertebral column and increasing mobility, resulting in passively stable vertebrae that are capable of substantial bending under appropriate loads.


Subject(s)
Armadillos/anatomy & histology , Armadillos/physiology , Lumbar Vertebrae/anatomy & histology , Lumbar Vertebrae/physiology , Thoracic Vertebrae/anatomy & histology , Thoracic Vertebrae/physiology , Animals , Biomechanical Phenomena , Calibration , Compliance , Principal Component Analysis , Range of Motion, Articular
20.
Am J Phys Anthropol ; 161(3): 467-477, 2016 11.
Article in English | MEDLINE | ID: mdl-27444750

ABSTRACT

OBJECTIVES: The human respiratory apparatus is characterized by sexual dimorphism, the cranial airways of males being larger (both absolutely and relatively) than those of females. These differences have been linked to sex-specific differences in body composition, bioenergetics, and respiratory function. However, whether morpho-functional variation in the thorax is also related to these features is less clear. We apply 3D geometric morphometrics to study these issues and their implications for respiratory function. MATERIAL AND METHODS: Four hundred two landmarks and semilandmarks were measured in CT-reconstructions of rib cages from adult healthy subjects (Nmale = 18; Nfemale = 24) in maximal inspiration (MI) and maximal expiration (ME). After Procrustes registration, size and shape data were analyzed by mean comparisons and regression analysis. Respiratory function was quantified through functional size, which is defined as the difference of rib cage size between MI and ME. RESULTS: Males showed significantly larger thorax size (p < .01) and functional size (p < .05) than females. In addition, the 3D-shape differed significantly between sexes (p < .01). Male rib cages were wider (particularly caudally) and shorter, with more horizontally oriented ribs when compared to females. While thorax widening and rib orientation were unrelated to allometry, thorax shortening showed a slight allometric signal. CONCLUSIONS: Our findings are in line with previous research on sexual dimorphism of the respiratory system. However, we add that thorax shortening observed previously in males is the only feature caused by allometry. The more horizontally oriented ribs and the wider thorax of males may indicate a greater diaphragmatic contribution to rib cage kinematics than in females, and differences in functional size fit with the need for greater oxygen intake in males.


Subject(s)
Thorax/anatomy & histology , Thorax/physiology , Adult , Aged , Anthropology, Physical , Anthropometry , Female , Humans , Male , Middle Aged , Ribs/anatomy & histology , Ribs/physiology , Sex Characteristics , Thoracic Vertebrae/anatomy & histology , Thoracic Vertebrae/physiology
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