Feasibility and accuracy of new insertion technique of S1 transpedicular screw. Computed tomography-based morphometric analysis

Objective To assess feasibility and accuracy of a new insertion technique of S1 transpedicular screw. Summary of background data Transpedicular stabilization in the first sacral vertebra (S1) is a technically demanding surgical procedure with inherent risk of loosening of the implant. A modification of the technique was recently proposed, along with the analytical verification which was performed based on the available literature. In the study, we performed radiological assessment of screws inserted into the S1 using the classical and modified techniques. Methods The analysis was performed in two parts. The first part was performed on eight cadaver specimens after implantation of the screws. In the second part, we used computed tomography images of patients with degenerative disk disease with a superimposed representation of screws. The thickness of the posterior cortex adherent to the screws, screw trajectory and their position with regard to the spinal canal was measured. The area of posterior cortex in contact with the screws was also calculated. Results The contact length and area was found to be two times greater for screws introduced with the modified technique. The convergence angle was comparable between the techniques, despite the shift of entry point. There was no canal breach, although with the modified technique the screws passed closer to the spinal canal. Conclusions The modified technique is considered safe. In this technique, the screws pass through a thicker portion of the posterior cortex compared to the classical technique that aims at improving the stability of the fixation

Analysis of trace element in intervertebral disc by Atomic Absorption Spectrometry techniques in degenerative disc disease in the Polish population

Objective Although trace elements are regarded crucial and their content has been determined in number of tissue there are only few papers addressing this problem in intervertebral disc in humans. Most of the trace elements are important substrates of enzymes influencing metabolism and senescence process. Others are markers of environmental pollution. Therefore the aim of the research was to analyzed of the trace element content in the intervertebral disc, which may be a vital argument recognizing the background of degenerative changes to be the effect of the environment or metabolic factors. Material and Methods Material consist of 18 intervertebral disc from 15 patients, acquired in surgical procedure of due to the degenerative disease with Atomic Absorption Spectrometry content of Al, Cd, Co, Pb, Cu, Ni, Mo, Mg, Zn was evaluated. Results Only 4 of the trace elements were detected in all samples. The correlation analysis showed significant positive age correlation with Al and negative in case of Co. Among elements significant positive correlation was observed between Al/Pb, Co/Mo, Al/Mg, Al/Zn Pb/Zn and Mg/Zn. Negative correlation was observed in Al/Co, Cd/Mg, Co/Mg, Mo/Mg, Co/Zn and Mo/Zn. Conclusions This study is the first to our knowledge that profiles the elements in intervertebral disc in patients with degenerative changes. We have confirmed significant differences between the trace element contents in intervertebral disc and other tissue. It can be ground for further investigation

Assessment of the Asymmetry of the Intervertebral Foramina within the Lower Motion Segments of the Lumbar Spine on the Computer Tomography Sections

Asymmetry in the degenerative lumbar spine may eventually evolve to debilitating scoliosis. The point where it starts to accelerate in some individuals is obscure. Discreet preclinical asymmetry may be a prognostic feature of the condition. The aim of this study was to assess the asymmetry of the intervertebral foramina of lower lumbar motion segments of the spine based on morphometric measurements using novel techniques of three-dimensional imaging. Computed tomography scans of 19 subjects with axial low back pain aged 50 to 78 of both sexes were digitally processed, and 3D reconstruction of L4/L5 and L5/S1 motion segments were obtained. The planes of intervertebral foramina were defined in reference to the axis of the pedicles bordering the intervertebral canal and the measurements were performed yielding absolute values in millimeters. The circumference ranged from 33.4 mm to 63.86 mm on the left side and from 33.01 mm to 73.54 mm on the right side. The horizontal dimension ranged from 6.86 mm to 17.84 mm on the left side and from 5.41 mm to 17.63 mm on the right side. The vertical dimension ranged from 10.17 mm to 23.65 mm on the left side and from 9.04 mm to 29.69 mm on the right side. All the measurements were combined to assess the asymmetry. Only in three cases (15%), symmetry in both segments was confirmed. No defined lateralization of asymmetry was found, as well as no significant link between the sex and age could be confirmed. This is the first study confirming the asymmetry among the intervertebral foramina. It seems that it is the dominant phenotype for intervertebral foramina. As the observed asymmetry lacks the dominant lateralization, it may be linked with the same trait of degenerative scoliosis. Though no direct link between the age and sex was confirmed in this study, it suggests other factors should be considered in prediction of the progress and magnitude of the deformity

Assessment of the Asymmetry of the Intervertebral Foramina within the Lower Motion Segments of the Lumbar Spine on the Computer Tomography Sections

Asymmetry in the degenerative lumbar spine may eventually evolve to debilitating scoliosis. The point where it starts to accelerate in some individuals is obscure. Discreet preclinical asymmetry may be a prognostic feature of the condition. The aim of this study was to assess the asymmetry of the intervertebral foramina of lower lumbar motion segments of the spine based on morphometric measurements using novel techniques of three-dimensional imaging. Computed tomography scans of 19 subjects with axial low back pain aged 50 to 78 of both sexes were digitally processed, and 3D reconstruction of L4/L5 and L5/S1 motion segments were obtained. The planes of intervertebral foramina were defined in reference to the axis of the pedicles bordering the intervertebral canal and the measurements were performed yielding absolute values in millimeters. The circumference ranged from 33.4 mm to 63.86 mm on the left side and from 33.01 mm to 73.54 mm on the right side. The horizontal dimension ranged from 6.86 mm to 17.84 mm on the left side and from 5.41 mm to 17.63 mm on the right side. The vertical dimension ranged from 10.17 mm to 23.65 mm on the left side and from 9.04 mm to 29.69 mm on the right side. All the measurements were combined to assess the asymmetry. Only in three cases (15%), symmetry in both segments was confirmed. No defined lateralization of asymmetry was found, as well as no significant link between the sex and age could be confirmed. This is the first study confirming the asymmetry among the intervertebral foramina. It seems that it is the dominant phenotype for intervertebral foramina. As the observed asymmetry lacks the dominant lateralization, it may be linked with the same trait of degenerative scoliosis. Though no direct link between the age and sex was confirmed in this study, it suggests other factors should be considered in prediction of the progress and magnitude of the deformity

Aktualne techniki rekonstrukcji 3D w tomografii komputerowej i rezonansie magnetycznym w diagnostyce obrazowej kręgosłupa

This review article presents an analysis of 36 scientific papers focusing on modern three-dimensional (3D) reconstruction techniques in computed tomography (CT) and magnetic resonance imaging (MRI) for their applications in medical diagnostics. The objective of this review is to present the current state of knowledge regarding the development and utilization of 3D reconstruction techniques, as well as to identify key trends and challenges in this field. The first part of the study focuses on the advancements in MRI and CT. The analysis reveals the major trends in the evolution of these diagnostic methods, such as increased accessibility of CT and MRI examinations for patients, reduced scan duration, greater utilization of artificial intelligence, and expanded applications in interventional radiology. The second part of the article highlights the potential and effectiveness of 3D modelling in diagnostic imaging. Creating 3D models of anatomical structures is a complex and multi-step process. Through the review, it was determined that 3D models derived from MRI can be equally accurate and diagnostically valuable compared to the more commonly used CT-based reconstructions. In the future, fusion imaging of MRI/CT is expected to play an increasingly significant role in orthopaedic imaging. The review demonstrates the significant potential of 3D modelling in diagnostic imaging. However, further research is still required to better understand the capabilities of 3D modelling in diagnosing complex anatomical structures. The integration of information technology in medicine will be crucial in advancing this field.Przedstawiono analizę 36 artykułów naukowych dotyczących nowoczesnych technik rekonstrukcji trójwymiarowych (3D) w tomografii komputerowej (CT) oraz rezonansie magnetycznym (MRI) w kontekście zastosowania tych technik w diagnostyce medycznej. Celem przeglądu jest zaprezentowanie aktualnego stanu wiedzy na temat rozwoju i zastosowania rekonstrukcji 3D oraz identyfikacja najważniejszych trendów i wyzwań w tej dziedzinie. W pierwszej części pracy skoncentrowano się na kierunkach rozwoju MRI i CT. Analiza wskazała główne trendy w ewolucji obu tych metod diagnostycznych, takie jak zwiększenie dostępności badań CT i MRI dla pacjentów, skrócenie czasu trwania badania, zwiększenie roli sztucznej inteligencji oraz szersze wykorzystanie tych modalności w radiologii interwencyjnej. Druga część pracy skupia się na możliwościach użycia modelowania 3D w diagnostyce obrazowej i jego skuteczności. Tworzenie trójwymiarowych modeli struktur anatomicznych to złożony i wieloetapowy proces. W toku przeglądu ustaliliśmy, że modele 3D uzyskane na podstawie MRI mogą być równie dokładne i posiadać podobną wartość diagnostyczną co wykorzystywane do tej pory rekonstrukcje oparte o obrazy CT. W przyszłości coraz większą rolę w diagnostyce obrazowej w ortopedii będą odgrywać obrazy fuzyjne MRI/CT. Przegląd pokazuje, że modelowanie 3D ma duży potencjał w diagnostyce obrazowej. Wciąż są jednak potrzebne dalsze badania, aby lepiej zrozumieć możliwości modelowania 3D w diagnostyce złożonych struktur anatomicznych. Wykorzystanie technologii informatycznych w medycynie będzie miało kluczowe znaczenie w tym procesie

Clinical and Demographic Factors Influencing the Asymmetry of Gait in Lower-Limb Prosthetic Users

(1) Background: A lower limb prosthesis replaces a lost body part with a differential representation of gait function and its symmetry. Many physical, personal, and specific factors in amputees influence gait asymmetry. The aim of this study was to determine the factors influencing the asymmetry of gait in amputated patients. (2) Methods: The study group consisted of 12 people. Gait quality was assessed using the MoCap OptiTrack® Motion Capture System and the results were correlated with demographic factors (age, gender), morphological features (height, weight), amputation-related factors (cause and side of amputation, prosthesis time, and prosthesis fixation), and ailment pain. The control group consisted of 12 people. (3) Results: In the study group, a positive correlation between the mean walking speed and height in the study group was demonstrated, as well as a positive correlation between the difference in ROM and height, and a negative correlation between the mean walking speed and age. A negative correlation between the difference in ROM and age was found in both groups. A positive correlation was found between the width of the support and the weight in the control group. No other statistical relationship with the parameters describing gait asymmetry was found. (4) Conclusions: Statistical analysis showed that mean walking speed and ROM difference in the study group were positively related to height and negatively to age. No other statistical relationship with the parameters describing gait asymmetry was found

New model of lumbar spine biomechanics with the use of simulation analysis

The existing biomechanical models of the lumbo-sacral spine do not explain the role of the dorsal extensor muscle and fascia. The study attempts to explain the action of paraspinal muscles based on the mechanism of contraction and “hydro skeleton”. It was assumed that the muscle contracting produces hydrostatic pressure and in this way is able to resist and transfer loads. In this mechanism, inside ventricular pressure can modify the load transfer through the spine. To confirm the hypothesis discussed above, a simplified simulation model of the lumbar spine was built. For this purpose, scientific software named ABAQUS, using finite element methods was used. The model of the spine was mainly a kinematic model aimed at reflecting the impact of the spinal muscle function on lumbar lordosis

Clinical and Demographic Factors Influencing the Asymmetry of Gait in Lower-Limb Prosthetic Users

(1) Background: A lower limb prosthesis replaces a lost body part with a differential representation of gait function and its symmetry. Many physical, personal, and specific factors in amputees influence gait asymmetry. The aim of this study was to determine the factors influencing the asymmetry of gait in amputated patients. (2) Methods: The study group consisted of 12 people. Gait quality was assessed using the MoCap OptiTrack® Motion Capture System and the results were correlated with demographic factors (age, gender), morphological features (height, weight), amputation-related factors (cause and side of amputation, prosthesis time, and prosthesis fixation), and ailment pain. The control group consisted of 12 people. (3) Results: In the study group, a positive correlation between the mean walking speed and height in the study group was demonstrated, as well as a positive correlation between the difference in ROM and height, and a negative correlation between the mean walking speed and age. A negative correlation between the difference in ROM and age was found in both groups. A positive correlation was found between the width of the support and the weight in the control group. No other statistical relationship with the parameters describing gait asymmetry was found. (4) Conclusions: Statistical analysis showed that mean walking speed and ROM difference in the study group were positively related to height and negatively to age. No other statistical relationship with the parameters describing gait asymmetry was found

Avascular Necrosis Bone Complication after Active COVID-19 Infection: Preliminary Results.

Background and objectives: The course of SARS-CoV-2 (COVID-19) is still under analysis. The majority of complications arising from the infection are related to the respiratory system. The adverse effect of the viral infection on bone and joint tissue has also been observed. Materials and Methods: We present a group of 10 patients with degeneration of large joints and adjacent epiphyses of long bones and the spine, with a background of bone infarctions and avascular necrosis (AVN) immediately after infection with the COVID-19 virus. In MR imaging, changes in the characteristics of AVN were documented. Results: Observation of this group showed a clear correlation among the history of COVID-19 disease in the patients, moderately severe symptoms, high levels of IgG antibodies, and the time of occurrence of joint changes. No other clinically significant complications were observed following COVID-19 infection in the study group. No other risk factors for AVN or autoimmune or degenerative diseases were found in the study group. The group of patients responded well to empirical treatment with steroids, which normalized acute inflammatory symptoms and pain in the joints. Conclusions: During coronavirus (COVID-19) infection, there are complications in the locomotor system, such as microembolism and the formation of AVN; hence, more research is needed

Analysis of trace element in intervertebral disc by Atomic Absorption Spectrometry techniques in degenerative disc disease in the Polish population

Objective Although trace elements are regarded crucial and their content has been determined in number of tissue there are only few papers addressing this problem in intervertebral disc in humans. Most of the trace elements are important substrates of enzymes influencing metabolism and senescence process. Others are markers of environmental pollution. Therefore the aim of the research was to analyzed of the trace element content in the intervertebral disc, which may be a vital argument recognizing the background of degenerative changes to be the effect of the environment or metabolic factors. Material and Methods Material consist of 18 intervertebral disc from 15 patients, acquired in surgical procedure of due to the degenerative disease with Atomic Absorption Spectrometry content of Al, Cd, Co, Pb, Cu, Ni, Mo, Mg, Zn was evaluated. Results Only 4 of the trace elements were detected in all samples. The correlation analysis showed significant positive age correlation with Al and negative in case of Co. Among elements significant positive correlation was observed between Al/Pb, Co/Mo, Al/Mg, Al/Zn Pb/Zn and Mg/Zn. Negative correlation was observed in Al/Co, Cd/Mg, Co/Mg, Mo/Mg, Co/Zn and Mo/Zn. Conclusions This study is the first to our knowledge that profiles the elements in intervertebral disc in patients with degenerative changes. We have confirmed significant differences between the trace element contents in intervertebral disc and other tissue. It can be ground for further investigation