Human lumbosacral root and ligamentum flavum thicknesses: a magnetic resonance study.

BACKGROUND: This study investigated the lumbosacral plexus (LSP) nerve root thickness and ligamentum flavum (LF) thickness and correlated them with age and sex. These findings provided a useful data for spinal nerve root micro-anastomosis surgery and lumbar decompression surgery. MATERIALS AND METHODS: This retrospective study was conducted with 350 individuals with ages ranging from 21 to 80 years under magnetic resonance imaging to evaluate the possible cause of a lower back pain. RESULTS: According to the morphometric measurements of the LSP root thickness, the diameter gradually increased from L1 to S1. L1 has the thinnest root (3.9 ± 0.81 mm) while S1 has the thickest root (5.45 ± 0.8 mm). The measurements revealed inconsiderable differences in the LSP thickness in relation to age, sex in the study population. Regarding the LF, the thickness of the LF was found to insignificantly increase with age. Besides, the LF thickness was inconsequentially higher in female. The mean thickness of the right LF at different spinal levels was measured (L2-L3 = 3.19 ± 0.27, L3-L4 = 3.38 ± 0.11 mm, L4-L5 = 3.71 ± 0.29 mm, and L5-S1 = 3.64 ± 0.21 mm). The mean thickness of the left LF was non-significantly higher. CONCLUSIONS: The LSP root and LF thicknesses not related to age or sex.

Influence of age, sex, height and lumber stenosis on the position of the conus medullaris in adults / Influencia de la edad, sexo, altura y estenosis lumbar en la posición del cono medular en adultos

Anatomical orientation of the termination level of Conus Medullaris (CM) has imperative role clinically for anesthetists and neurosurgeons which is considered as an objective guide to perform spinal anesthesia and spinal punctures circumspectly with less chance to have serious injuries. The current retrospective study was carried on to determine the location of the CM and how its termination level can be influenced by age, sex, height and lumber stenosis spine disease. The study included 462 participants that consisted of 199 men and 263 women range from 21 to 80 years of age and height range between 150-190 cm. Also, it included 150 lumber stenosis patients. The location of the CM was imaged using a series of magnetic resonance images (MRI) for the lumbosacral spine at different levels including, T12, T12-L1, L1, L1-L2, and L2. The measurements revealed inconsiderable differences in the CM termination level in relation to age, sex and height in a healthy study population. Moreover, the results showed insignificant differences in the CM termination level between men and women whether they are healthy or having lumbar spinal stenosis. In conclusion, the most common level of CM termination is at L1 followed by L1-L2. It is safe to perform a lumbar neuraxial procedures at the level of L3-L4.

La orientación anatómica del nivel de terminación del Conus medullaris (CM) tiene un importante papel clínico para los anestesistas y neurocirujanos, que se considera una guía objetiva para realizar la anestesia espinal y las punciones de la columna circunspectivamente con menos posibilidades de provocar lesiones graves. Se llevó a cabo un estudio retrospectivo para determinar la ubicación del CM y cómo su nivel de terminación puede verse afectado por la edad, el sexo, la altura y una patología de la columna vertebral, la estenosis lumbar. El estudio incluyó 462 participantes que consistían en 199 hombres y 263 mujeres de 21 a 80 años de edad y una altura de entre 150-190 cm. Además, se incluyeron 150 pacientes con estenosis lumbar. La ubicación del CM se determinó mediante una serie de imágenes de resonancia magnética (RM) de la columna lumbosacra a diferentes niveles, incluidos T12, T12-L1, L1, L1-L2 y L2. Las mediciones revelaron diferencias considerables en el nivel de terminación de CM en relación con la edad, el sexo o la altura en una población de estudio saludable. Además, los resultados mostraron diferencias poco significativas en el nivel de terminación de CM entre hombres y mujeres, sanos o con estenosis espinal lumbar. En conclusión, se encontró que el nivel más común de terminación del CM es L1 seguido de L1-L2, considerándose seguro realizar procedimientos neuroaxiales lumbares a nivel de L3-L4.

The carrying angle: racial differences and relevance to inter-epicondylar distance of the humerus.

The human carrying angle (CA) is a measure of the lateral deflection of the forearm from the arm. The importance of this angle emerges from its functional and clinical relevance. Previous studies have correlated this angle with different parameters including age, gender, and handedness. However, no reports have focused on race-dependent variations in CA or its relation to various components of the elbow joint. This study aimed to investigate the variations in CA with respect to race and inter-epicondylar distance (IED) of the humerus. The study included 457 Jordanian and 345 Malaysian volunteers with an age range of 18-21 years. All participants were right-hand dominant with no previous medical history in their upper limbs. Both CA and IED were measured by well-trained medical practitioners according to a well-established protocol. Regardless of race, CA was greater on the dominant side and in females. Furthermore, CA was significantly greater in Malaysian males compared to Jordanian males, and significantly smaller in Malaysian females compared to their Jordanian counterparts. Finally, CA significantly decreased with increasing IED in both races. This study supports effects of gender and handedness on the CA independent of race. However, CA also varies with race, and this variation is independent of age, gender, and handedness. The evaluation also revealed an inverse relationship between CA and IED. These findings indicate that multiple factors including race and IED should be considered during the examination and management of elbow fractures and epicondylar diseases.

Prevalence and distribution of high-risk human papillomavirus genotypes in cervical carcinoma, low-grade, and high-grade squamous intraepithelial lesions in Jordanian women.

PURPOSE: To assess high-risk human papillomavirus (HR-HPV) prevalence, and genotype distribution in invasive cervical cancer (CC) and its precursors in Jordanian patients. MATERIALS AND METHODS: A total of 124 different specimens of formalin-fixed, paraffin embedded samples, including 18 low-grade squamous intraepithelial lesions (LSILs), 28 high grade squamous intraepithelial lesions (HSILs), and 78 CCs were included in this study. HPV detection and typing was done using HPV High Risk Typing Real-TM Kit that enables the concomitant detection of the 12 most common HR-HPVs. RESULTS: Overall, HR-HPV prevalence was 87.2%, 78.6%, and 72.2% in CC, HSIL, and LSIL respectively. Genotype 16 was the most predominant in all cervical lesions, detected in 53.8%, 46.4%, and 38.9% of CC, HSIL, and LSIL, respectively. Among all HPV genotypes, HPV-16 and HPV-18 were found separately or together in 50% of LSILs, 60.7% of HSILs, and 76.9% of CC specimens. HPV-31 was the second most common type detected in LSILs (22.2%) and HSILs (21.4%). HPV-45 was the third most common type detected in CC (11.5%). CONCLUSION: The prevalence and genotypes distribution patterns of HR-HPV types among patients with CC and its precursors in Jordan are similar to known international patterns. The results of this study provide baseline information on the HPV type distribution, which may guide the development of CC prevention and control programs in Jordan.