Association between facet joint orientation/tropism and lumbar intervertebral disc degeneration.

Background: The aim of this study was to understand how facet joint orientation (FJO) and facet joint tropism (FJT) affected severe intervertebral disc degeneration (IVDD) process at lower lumbar levels in patients with LBP.Methods: This study is a cross-sectional analysis of a retrospective database. Patients were evaluated in terms of IVDD, FJO, and FJT at all lumbar levels on magnetic resonance imaging.Results: In this study (n: 123) facet joints were aligned more coronal in men than in women at upper lumbar levels. Men had less FJT compared to women, significantly at L2-L3 and L3-L4 levels. Severe IVDD at L4-L5 was associated with more coronal aligned L1-L2 (29.0 ± 2.5° vs. 23.3 ± 2.3°, p = 0.006) and misaligned L5-S1 (8.3 ± 1.9° vs. 4.5 ± 1.7°, p = 0.008). Besides, severe IVDD at L3-L4 was associated with more coronal aligned L4-L5 (49.1 ± 3.2° vs. 41.4 ± 2.8°, p = 0.014).Conclusion: There is a close association between FJO/FJT with lumbar IVDD. Facet joint orientation and FJT do not affect the disc at only the corresponding level; the lumbar spine should be evaluated as a whole.

Within-subject and between-subject biological variation estimates of 21 hematological parameters in 30 healthy subjects.

BACKGROUND: The complete blood count (CBC) is used to evaluate health status in the contexts of various clinical situations such as anemia, infection, inflammation, trauma, malignancies, etc. To ensure safe clinical application of the CBC, reliable biological variation (BV) data are required. The study aim was to define the BVs of CBC parameters employing a strict protocol. METHODS: Blood samples, drawn from 30 healthy subjects (17 females, 13 males) once weekly for 10 weeks, were analyzed using a Sysmex XN 3000 instrument. The data were assessed for normality, trends, outliers and variance homogeneity prior to coefficient of variation (CV)-analysis of variance (ANOVA). Sex-stratified within-subject (CVI) and between-subjects (CVG) BV estimates were determined for 21 CBC parameters. RESULTS: For leukocyte parameters, with the exception of lymphocytes and basophils, significant differences were found between female/male CVI estimates. The mean values of all erythrocyte-, reticulocyte- and platelet parameters differed significantly between the sexes, except for mean corpuscular hemoglobin concentration, mean corpuscular volume and platelet numbers. Most CVI and CVG estimates appear to be lower than those previously published. CONCLUSIONS: Our study, based on a rigorous protocol, provides updated and more stringent BV estimates for CBC parameters. Sex stratification of data is necessary when exploring the significance of changes in consecutive results and when setting analytical performance specifications.

Schmorl's nodes could be associated with intervertebral disc degeneration at upper lumbar levels and end-plate disease at lower lumbar level in patients with low back pain.

Schmorl's nodes (SNs) have increasingly been recognized on vertebral end-plates using advanced imaging techniques. Even though vertebral end-plates are the closest structures to discs, their pathologies are underestimated in the etiology of low back pain (LBP). We aimed to detect the prevalence of SNs and other end-plate defects in subjects with/without LBP and to understand whether SNs were associated with LBP and spinal degeneration. Subjects were evaluated in terms of end-plate defects, intervertebral disc degeneration (IVDD), and vertebral end-plate changes (Modic changes) at all lumbar levels on lumbar spine magnetic resonance imagings (MRI). Control subjects were compared to patients with LBP. Higher Pfirrmann scores (OR: 2.696) and higher SN scores (OR: 8.076) were significantly associated with Modic changes at L4-L5 disc level. Patients with higher SN scores at L1-L2 or L2-L3 levels had approximately 7-fold increased risk of severe IVDD at the corresponding levels. The most significant factor associated with presence of SNs was body weight of the patients (OR: 1.417). The most significant factor associated with intensity of LBP was severe IVDD at L5-S1 level (OR: 3.670). Having higher total SN score had an OR of 1.230 (95% CI: 1.003-1.509; p = 0.047) for predicting LBP. Schmorl's nodes were seen in 33.1% of patients and 11.5% of asymptomatic subjects. Body weight was the most significant factor associated with SNs. The most significant factor associated with LBP was severe IVDD at L5-S1 level.

Lumbar intervertebral disc degeneration, end-plates and paraspinal muscle changes in children and adolescents with low-back pain.

The prevalence of low-back pain (LBP) in adolescents ranges from 7 to 72%. We aimed to define the radiologic characteristics of the lumbar spine in children and adolescents with LBP with/without leg pain. Two hundred and fourteen children and adolescents, who were born between 2001 and 2009 and had lumbar spine MRI for LBP with/without leg pain, were evaluated in terms of intervertebral disc degeneration (IVDD), end-plates and paraspinal muscle changes on lumbar spine MRIs. Severe IVDD was detected at all lumbar levels except for L2-L3. Modic changes were present in 4.2% of the patients. Modic changes were more common in patients with severe IVDD than in those with mild-to-moderate IVDD. Severe IVDD was significantly associated with Modic changes at the corresponding L1-L2 and L3-L4 disc levels. Girls had significantly more fatty infiltration in the paraspinal muscles when compared to boys. The risk of having severe IVDD concomitant with Modic changes was high [odds ratio (OR), 8.6]. The OR was 20.7 for predicting the presence of severe IVDD at any level if Modic changes presented particularly at the L3-L4 level. The ORs of Modic changes presented at any lumbar level at the background of fat-infiltrated multifidus at L3-L4 and L4-L5 levels were 8.3 and 9.1, respectively. Fatty infiltration in the paraspinal muscles and IVDD were closely associated with Modic changes in children and adolescents with LBP. Lumbar IVDD in children and adolescents could be the result of a mechanical pathology.

Prevalence of Thoracic Scoliosis in Adolescents in Turkey: Analysis of 1065 Chest Radiographs.

BACKGROUND: School scoliosis screening programs (SSSPs) are widely used for reporting the prevalence and improving the awareness of scoliosis. Thus, scoliosis could be prevented and/or treated in a timely manner. However, mild scoliosis (10°-20°) could be missed in SSSPs. Previously obtained plain chest radiographs could be used as an adjunct to SSSPs to detect the exact prevalence of scoliosis. In this study, we aimed to detect the prevalence of thoracic scoliosis in adolescents in Turkey using posteroanterior chest radiographs. METHODS: We conducted a cross-sectional radiologic study evaluating plain chest radiographs in adolescents who visited the emergency department or outpatient clinics at a community-based hospital. We also reviewed the literature regarding scoliosis screening in adolescents using the PubMed/MEDLINE search engine. RESULTS: We included 1065 adolescents. Thoracic scoliosis was detected on plain posteroanterior chest radiographs in 10.4% of the adolescents. The prevalence of thoracic scoliosis was significantly larger in females compared with males (12.3% vs. 8.6%; P = 0.047). We retrieved 140 articles regarding scoliosis screening in adolescents from the literature. Each continent had different scoliosis prevalence (according to Cobb angle ≥10° verified on a radiograph). CONCLUSIONS: SSSPs help detection of the prevalence of scoliosis and the factors associated with scoliosis in adolescents. However, patients with small-angle curves could be missed in SSSPs. Our results showed that plain posteroanterior chest radiographs could be used as an adjunct to SSSPs to accurately detect prevalence of scoliosis in adolescents.

Neuro-Ophthalmological Manifestations Of Septo-Optic Dysplasia: Current Perspectives.

Septo-optic dysplasia (SOD), also known as de Morsier syndrome, is a rare congenital disorder belonging to the group of mid-line brain malformations. Despite the highly variable phenotypic penetration, its classical triad include a) optic nerve hypoplasia (ONH), b) agenesis of septum pellucidum and corpus callosum, and c) hypoplasia of the hypothalamo-pituitary axis. SOD has stringent diagnostic criteria requiring 2 or more features of the classic triad, therefore it represents a separate entity from other conditions such as ONH and achiasmia syndromes which share only some of these aspects, or SOD plus syndrome which is characterized by additional cortical abnormalities. Starting from its etiology and epidemiology, this narrative review focuses on the management of SOD patients, including their diagnosis, treatment and follow-up. To date, SOD is not curable; nonetheless, many of its symptoms can be improved through a tailored approach, consisting of hormonal replacement, corrective ophthalmological surgery and neuropsychological support.