Population-Stratified Analysis of Bone Mineral Density Distribution in Cervical and Lumbar Vertebrae of Chinese from Quantitative Computed Tomography

Yong Zhang,Zhuang Zhou,Cheng’ai Wu,Danhui Zhao,Chao Wang,Xiaoguang Cheng,Wei Cai,Ling Wang,Yangyang Duanmu,Chenxin Zhang,Wei Tian 대한영상의학회 2016 Korean Journal of Radiology Vol.17 No.5

Objective: To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. Materials and Methods: Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2–7 and L2–4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. Results: The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2–5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62–0.94; males: r = 0.63–0.94) and lumbar vertebrae (males: r = 0.93–0.98; females: r = 0.82–0.97) were statistically significant at each age group. Conclusion: The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.

Lumbar Morphometry: A Study of Lumbar Vertebrae from a Pakistani Population Using Computed Tomography Scans

Muhammad M Alam,Muhammad Waqas,Hussain Shallwani,Gohar Javed 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.4

Study Design: A cross-sectional study. Purpose: To describe the characteristics of lumbar vertebrae of Pakistani patients reporting at a tertiary care hospital and compare with studies from other populations. Overview of Literature: Several studies have been conducted to determine morphometry of lumbar vertebrae. Most of the studies involve Caucasian populations, still data on other populations still sparse. This is the first study describing lumbar morphometry of a Pakistani population. Methods: An observational study was conducted based on a review of thin-cut (3 mm) computed topographic images of lumbar vertebrae. Two-hundred and twenty vertebrae from forty-nine patients were studied, and various dimensions were analyzed. Results: Generally, the size of the vertebrae, vertebral canals and recesses were found to be greater in male patients. The difference was statistically significant for transverse and anteroposterior diameters of the vertebral bodies and sagittal diameter of pedicles on the left side (p <0.05). Comparison of populations revealed statistically significant differences in pedicle dimensions between Pakistani population and others. Conclusions: This study provides anatomical knowledge of the lumbar region in a sample population of Pakistan. There were significant differences in various dimensions of lumbar vertebrae between female and male patients. This would prove to be critical for performing a safe operation.

Role of Anatomical Landmarks in Identifying Normal and Transitional Vertebra in Lumbar Spine Magnetic Resonance Imaging

Devimeenal Jagannathan,Venkatraman Indiran,Fouzal Hithaya,M. Alamelu,S. Padmanaban 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.3

Study Design: Retrospective study. Purpose: Identification of transitional vertebra is important in spine imaging, especially in presurgical planning. Pasted images of the whole spine obtained using high-field magnetic resonance imaging (MRI) are helpful in counting vertebrae and identifying transitional vertebrae. Counting vertebrae and identifying transitional vertebrae is challenging in isolated studies of lumbar spine and in studies conducted in low-field MRI. An incorrect evaluation may lead to wrong-level treatment. Here, we identify the location of different anatomical structures that can help in counting and identifying vertebrae. Overview of Literature: Many studies have assessed the vertebral segments using various anatomical structures such as costal facets (CF), aortic bifurcation (AB), inferior vena cava confluence (IC), right renal artery (RRA), celiac trunk (CT), superior mesenteric artery root (SR), iliolumbar ligament (ILL) psoas muscle (PM) origin, and conus medullaris. However, none have yielded any consistent results. Methods: We studied the locations of the anatomical structures CF, AB, IC, RRA, CT, SR, ILL, and PM in patients who underwent whole spine MRI at our department. Results: In our study, 81.4% patients had normal spinal segmentation, 14.7% had sacralization, and 3.8% had lumbarization. Vascular landmarks had variable origin. There were caudal and cranial shifts with respect to lumbarization and sacralization. In 93.8% of cases in the normal group, ILL emerged from either L5 alone or the adjacent disc. In the sacralization group, ILL was commonly seen in L5. In the lumbarization group, ILL emerged from L5 and the adjacent disc (66.6%). CFs were identified at D12 in 96.9% and 91.7% of patients in the normal and lumbarization groups, respectively. The PM origin was observed from D12 or D12–L1 in most patients in the normal and sacralization groups. Conclusions: CF, PM, and ILL were good identification markers for D12 and L5, but none were 100% accurate.

말의 요추골유합과 요추골변형의 증례

김종섭,강병일,고필옥,조규완,허찬권,원청길,Kim, Chong-Sup,Kang, Byoung-Il,Koh, Phil-Ok,Cho, Kyu-Woan,Huh, Chan-Kwen,Won, Chung-Kil 대한수의학회 2004 大韓獸醫學會誌 Vol.44 No.1

The fused and deformed lumbar vertebrae (L) of Thoroughbred horses were observed macroscopically. Results revealed five L in two cases, and six L in three cases. In two cases, the last two lumbar vertebrae were fused with each other. One case of the fused lumbar vertebra was observed in a horse with five L and the other in that with six L. In one case, the facet of second last lumbar vertebra was articulated with its anterior lumbar vertebra. On the other hand, four cases had the caudal border on the lateral tip of the lumbar transverse process partially overlapped with the cranial border of the following lumbar transverse process. In these cases, cranial and caudal tubers were formed on the overlapped part of the lumbar transverse process.

DMZ 화살머리고지에서 발굴된 6·25 전사 서양인 사람뼈에서 발견된 쉬모를 결절과 불완전 허리뼈되기

장유량,김명주 대한체질인류학회 2019 해부·생물인류학 (Anat Biol Anthropol) Vol.32 No.4

The Ministry of National Defense of Agency for KIA Recovery and Identification (MAKRI) launched the Korean War casualty excavation project to retrieve war remains at the Arrowhead Ridge in the DMZ by affecting the mood of peace-building and inter-Korean tension-reducing, and uncovered possible Korean War casualty’s remains. The present case of excavated bones was well-preserved and the rate of preservation was more than 97%. As an identification results of this case, the ethnicity, age, stature was estimated as European, 16~19 years old, 163~169.5 cm respectively. Schmorl’s nodes and partial lumbarization of the sacrum were observed in the anthropological and forensic examination. Multiple Schmorl’s nodes as various sizes were localized in the upper and lower surface of the vertebral endplate from lower thoracic vertebrae (T8~T12) to lumbar vertebrae (L1~L5). A partial lumbarization of S1 was also observed in the sacrum. In this case, we suggested the hypothesis that Schmorl’s node and partial lumbarization of S1 can simultaneously occur even in the young age as a course of functional adaptation in regarding to the morphological features of the constituent elements of the vertebrae. Further studies for the biomechanical mechanism of Schmorl’s node and lumbarization of S1 in various ethnic groups of large population will reveal more about the relationship between the morphological features of the vertebrae and the bony lesions. 국방부 유해발굴감식단 (MAKRI)은 남북관계 개선으로 비무장지대의 화살머리고지에서 유해발굴사업을진행하여 한국전쟁 전사자로 추정되는 사람들의 뼈를 다수 발굴하였다. 발굴된 사람뼈 중 한 개체는 전체 잔존율이97%로 보존 상태가 양호하였으며, 감식을 통해 연령 16~19세, 신장 163~169.5 cm로 추정되는 서양인임을 확인하였다. 발굴된 뼈의 체질인류학적 조사 결과, 주요 병변으로 쉬모를 결절과 엉치뼈의 불완전 허리뼈되기가 있음을 확인하었다. 쉬모를 결절은 여덟째등뼈~열두번째등뼈 (T8~T12), 첫째허리뼈~다섯째허리뼈 (L1~L5) 몸통 윗면과 아랫면에서 다양한 크기로 관찰되었으며, 엉치뼈에서 S1 분절의 불완전 허리뼈되기도 관찰되었다. 본 사례를 통해 척추를 구성하는 요소들의 형태적 특징들과 관련해 쉬모를 결절과 엉치뼈 (S1)의 허리뼈되기가 젊은연령에서도 기능적 적응의 과정에서 동시에 발생할 수 있음을 보여주었다. 다양한 인구 집단에서 쉬모를 결절과 허리뼈되기의 병인에 대한 추가 연구가 수행된다면 척추의 형태학적 특징과 병변의 상관관계에 대해 더 많은 것을 증명할수 있을 것이다.

Standardized Uptake Value from Semiquantitative Bone Single-Photon Emission Computed Tomography/Computed Tomography in Normal Thoracic and Lumbar Vertebrae of Breast Cancer Patients

Rohani Mohd Fazrin Mohd,Yonan Siti Nurshahirah Mohd,Tagiling Nashrulhaq,Zainon Wan Mohd Nazlee Wan,Udin Yusri,Nawi Norazlina Mat 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.5

Study Design: Retrospective study.Purpose: This study aims to semiquantitatively evaluate the standardized uptake value (SUV) of ^99mTc-methylene diphosphonate (MDP) radionuclide tracer in the normal vertebrae of breast cancer patients using an integrated single-photon emission computed tomography (SPECT)/computed tomography (CT) scanner.Overview of Literature: Molecular imaging techniques using gamma cameras and stand-alone SPECT have traditionally been utilized to evaluate metastatic bone diseases. However, these methods lack quantitative analysis capabilities, impeding accurate uptake characterization.Methods: A total of 30 randomly selected female breast cancer patients were enrolled in this study. The SUVmean and SUVmax values for 286 normal vertebrae at the thoracic and lumbar levels were calculated based on the patients’ body weight (BW), body surface area (BSA), and lean body mass (LBM). Additionally, 106 degenerative joint disease (DJD) lesions of the spine were also characterized, and both their BW SUVmean and SUVmax values were obtained. A receiver operating characteristic (ROC) curve analysis was then performed to determine the cutoff value of SUV for differentiating DJD from normal vertebrae.Results: The mean±standard deviations for the SUVmean and SUVmax in the normal vertebrae displayed a relatively wide variability: BW=3.92±0.27 and 6.51±0.72, BSA=1.05±0.07 and 1.75±0.17, and LBM=2.70±0.19 and 4.50±0.44, respectively. Generally, the SUVmean had a lower coefficient of variation than the SUVmax. For DJD, the mean±standard deviation for the BW SUVmean and SUVmax was 5.26±3.24 and 7.50±4.34, respectively. Based on the ROC curve, no optimal cutoff value was found to differentiate DJD from normal vertebrae.Conclusions: In this study, the SUV of ^99mTc-MDP was successfully determined using SPECT/CT. This research provides an approach that could potentially aid in the clinical quantification of radionuclide uptake in normal vertebrae for the management of breast cancer patients.

비만에 의한 허리뼈 전만과 추간판 각도의 영향에 관한 연구

곽종혁,최민경,김능균,김아연,김성진 한국방사선학회 2020 한국방사선학회 논문지 Vol.14 No.3

Lumbar Lordosis Angle (LLA) is an index that can be used to evaluate the curvature of the lumbar vertebrae. It can measure the structural stability of the lumbar spine and the stability of each segment of the vertebral column at the intervertebral disc angle (IDA). Especially, our data shows it is found to be a strong positive correlation between obesity and the angle of lordosis for lumbar vertebrae. Also, the reason for the large IDA in the case of obesity seems to be the result of the weakening of anatomical structure as well as the gravity effect. And, the obesity interferes with normal sagittal balance and fails to maintain a straight posture with minimal energy. Therefore, the obesity can be an important factor in causing back pain by changing the lumbar lordosis. 허리뼈 전만각(LLA)은 허리뼈의 곡률을 평가하는 데 사용할 수 있는 지표이다. 허리뼈의 구조적 안정성과 추간판 각도(IDA)에서 척추의 각 부분의 안정성을 측정할 수 있다. 특히, 본 연구 자료에 따르면 허리뼈에 대한 비만과 전만각 사이에는 강한 양의 상관관계가 있는 것으로 나타났다. 또한, 비만의 경우 IDA가 큰 이유는 해부학적 구조의 약화와 중력 효과의 결과인 것으로 보인다. 비만은 정상적인 시상면 균형을 방해하고 최소한의 에너지로 똑바른 자세를 유지하지 못한다. 따라서 비만은 허리뼈 전만증을 변화시켜 요통을 유발하는 중요한 요소가 될 수 있다.

Distribution and length of osteophytes in the lumbar vertebrae and risk of rupture of abdominal aortic aneurysms: a study of dry bones from Chiang Mai, Thailand

Patcharin Chanapa,Tohno Yoshiyuki,Pasuk Mahakkanukrauh 대한해부학회 2014 Anatomy & Cell Biology Vol.47 No.3

Vertebral osteophytes are a characteristic feature of intervertebral disc degeneration. In the lumbar spinal region, the two major structures in close proximity anterior to the spine are the inferior vena cava and the abdominal aorta, both of which have been reported to be affected by osteophytes. The purpose of this study was to determine the distribution, classification and lengths of osteophytes in the lumbar vertebrae. One hundred and eighty lumbar columns of 90 males and 90 females from Chiang Mai, Thailand, in the age range 15 to 96 years (mean age, 63 years) were collected. The measuring length of osteophytes was assessed on vertebral body and articular facet. Statistical analysis was performed by descriptive analysis, chi-square and Pearson Correlation. Lumbar osteophytes were presented in 175 specimens (97.2%), 88 males and 87 females. The highest frequency was at L4, most were on the superior, inferior surface of body and articular facet (39.7%, 38.4%, and 22%), respectively. The greatest mean length was 3.47±2.21 mm at L5, and the longest length of anterior superior surface of body was 28.56 mm. The osteophyte length was significantly correlated directly with age (P<0.01), and males were significantly greater than females (P<0.05). The highest prevalence of osteophytes was on the anterior side of superior surface of body (30.4%), and the classification was traction. It can be proposed that the abdominal aorta could be damaged, especially a risk of rupture of abdominal aortic aneurysm.

Chondroblastoma of the Lumbar Spine - A Case Report and Review of the Literature -

김선아,조경자,박용구,이종석,권현주,정혜원,김미정 대한병리학회 2011 Journal of Pathology and Translational Medicine Vol.45 No.5

We report a case of chondroblastoma arising in the lumbar spine in a 25-year-old man who presented with low back pain of 5 years duration. Plain radiography and computed tomography revealed a well-defined osteolytic mass surrounded by marginal sclerosis in the third lumbar vertebra. The mass encroached on the left neural foramen on magnetic resonance imaging. Histologically, the tumor consisted of round to oval cells with eosinophilic cytoplasm and randomly scattered osteoclastic type giant cells. There were characteristic chicken-wire calcification and aneurysmal bone cyst-like changes. Chondroblastomas of the lumbar spine are extremely rare, and only nine cases have been reported. Spinal chondroblastoma should be distinguished from other benign bone tumors, because it tends to show aggressive biological behavior with high recurrence and mortality rates.

Deterioration of Trabecular Bone Microarchitecture in the Lumbar Vertebrae in Growing Male Mice Following Sciatic Neurectomy

고창용,김한성,정영진,서동현,이상대 한국정밀공학회 2014 International Journal of Precision Engineering and Vol.15 No.12

Sciatic nerve injury (SNI) can lead to significant bone loss in the lower extremities. However, the effects of SNI on the lumbarvertebrae are controversial. The present study aimed to evaluate the longitudinal effects of SNI on the lumbar vertebrae. Twenty-four12-week-old male C57BL/6 mice (24.55±0.17 g) were randomly assigned to 3 groups (8 mice each) and underwent unilateral sciaticneurectomy (USN group), bilateral sciatic neurectomy (BSN group), or no surgery (CON group). The third (L3) and fourth (L4)lumbar vertebrae were scanned by in-vivo micro-computed tomography (ìCT) preoperatively and at 14 and 28 days postoperatively. Using μCT images, structural parameters and bone mineralization density distribution of the trabecular bone were analyzed amongthe 3 groups. In the BSN group, structural and material properties of L3 and L4 worsened after 14 days. Deterioration in the structuralproperties of L3 was observed at 28 days in the USN group, whereas no changes were observed in L4. These results implied that SNIcan cause considerable deterioration in the microarchitecture of trabecular bone in the lumbar vertebrae. However, differences in themagnitude and rate of the deterioration and its onset period are observed between cases of unilateral and bilateral SNI.