Foramen Area Research Articles

Pedicle distraction increases vertebral foramen area—a pilot study

BACKGROUND CONTEXT: Lumbar spine stenosis, a degenerative condition, involves narrowing of the spinal canal or intervertebral foramen. Surgical management involves laminectomy to decompress the entrapped nerves; however, this technique causes significant trauma and vertebral instability. The proposed minimally invasive technique involves increasing pedicle length to decompress affected nerves.

Dimensions of the cervical neural foramen in conditions of spinal deformity: an ex vivo biomechanical investigation using specimen-specific CT imaging.

Patients with cervical spondylosis commonly present with neck pain, radiculopathy or myelopathy. As degenerative changes progress, multiple factors including disc height loss, thoracic kyphosis, and facetogenic changes can increase the risk of neural structure compression. This study investigated the impact of cervical deformity including forward head posture (FHP) and upper thoracic kyphosis, on the anatomy of the cervical neural foramen. Postural changes of 13 human cervical spine specimens (Occiput-T1, age 50.6years; range 21-67) were assessed in response to prescribed cervical sagittal malalignments using a previously reported experimental model. Two characteristics of cervical sagittal deformities, C2-C7 sagittal vertical alignment (SVA) and sagittal angle of the T1 vertebra (T1 tilt), were varied to create various cervical malalignments. The postural changes were documented by measuring vertebral positions and orientations. The vertebral motion data were combined with specimen-specific CT-based anatomical models, which allowed assessments of foraminal areas of subaxial cervical segments as a function of increasing C2-C7 SVA and changing T1 tilt. Increasing C2-C7 SVA from neutral posture resulted in increased neural foraminal area in the lower cervical spine (largest increase at C4-C5: 13.8±15.7%, P<0.01). Increasing SVA from a hyperkyphotic posture (greater T1 tilt) also increased the neural foraminal area in the lower cervical segments (C5-C6 demonstrated the largest increase: 13.4±9.6%, P<0.01). The area of the cervical neural foramen decreased with increasing T1 tilt, with greater reduction occurring in the lower cervical spine, specifically at C5-C6 (-8.6±7.0%, P<0.01) and C6-C7 (-9.6±5.6%, P<0.01). An increase in thoracic kyphosis (T1 tilt) decreased cervical neural foraminal areas. In contrast, an increase in cervical SVA increased the lower cervical neural foraminal areas. Patients with increased upper thoracic kyphosis may respond with increased cervical SVA as a compensatory mechanism to increase their lower cervical neural foraminal area.

Use of Autologous Serum in Treatment of Lumbar Radiculopathy Pain. Pilot Study

The aim of the study was to determine the usefulness of autologous serum in the treatment of patients with signs of radicular compression in the course of lumbar discopathy. The treatment was based on the use of autologous conditioned serum (ACS, Orthokine). A total of 15 patients with MRI-confirmed single-level nucleus pulposus herniation with signs of radicular compression without paresis in a clinical examination received 6 doses of ACS administered by the same doctor under ultrasound guidance from a posterolateral approach to the area of an intervertebral foramen. The clinical condition of the patients was reassessed at 1 month and 3 months after the administration of the last dose. Pain intensity was assessed with a scoring system and a VAS scale, and radicular oedema was assessed with the following clinical tests: one-leg stance (OLS test) and straight leg raise (SLR test); the disability level was measured with the Oswestry Disability Index. Out of 15 patients, 2 persons had to undergo surgery due to increasing pain. The other subjects showed a statistically significant reduction of pain and clinical signs of radicular compression as well as improved Oswestry scores. No radicular damage following injections or serious complications of the treatment were found. 1. The Orthokine therapy conducted under ultrasound guidance may be an interesting option in the treatment of compression radiculopathy in the course of radicular compression due to a herniated disc. 2. The present pilot study provides the rationale for studying larger groups of subjects in controlled studies over longer periods of time.

Analysis of pelvic rotation on the standard hip ventrodorsal extended radiographic view.

To study the symmetry of the iliac horizontal diameter (IHD) maximum obturator foramen width (OFW), ischiatic femoral overlap (IFO), pelvic horizontal radius (PHR), femoral head diameter (FHD), and obturator foramen area (OFA) parameters in the normal hip extended radiographic view and to evaluate the correlation of pelvic rotation with the magnitude of asymmetry of these parameters. Nine canine cadavers from adult, large and giant breeds were radiographed in standard hip extended views and with 2°, 4° and 6° degrees of rotation. The variables IHD, OFW, IFO, PHR, FHD, and OFA were analysed in radiographs. The IHD measurements exhibited repeatability, bilateral symmetry and 95% of confidence interval of asymmetry in different pelvic rotations without superposition (p<0.05); OFW and IFO exhibited repeatability, bilateral symmetry and a small superposition in 95% of confidence interval of asymmetry according different pelvic rotations; PHR, FHD and OFA exhibited repeatability, bilateral symmetry and unacceptable superposition in 95% of confidence interval of asymmetry depending on pelvic rotation. The IHD is the recommended variable and OFW is an acceptable variable in order to evaluate slight pelvic rotation. The data may be used in qualitative analyses of hip extended radiographic views. In the future, complementary studies should be performed to evaluate the impact of degree of pelvic rotation on the hip dysplasia score.

The evaluation of relationship between body mass index and mental foramen area using computer-aided methods

Objective: Anatomical structure of the mental foramen (MF) is an essential orientation point particularly for implant planning at surgical clinics of dentistry, for genioplasty operations, and plastic surgery. The aim is to determine the influential factors such as the patient age, gender, and body mass index (BMI) on MF anatomy of dental periapical radiograms. Materials and Methods: Our study evaluated the BMI, gender, and age relationship with the calculated areas of the MF based on symmetrically taken 202 periapical dental radiography with a parallel technique of the bottom premolar region of total 101 people ages ranging from 17 to 70 weighing 46–108 kg. Patient age, BMI, and gender were recorded and statistically tested for correlations on the area of the MF. Digital imaging and communications in medicine were measured MF area. Results: Right MF area was measured as 0–20.8 mm2 (mean: 4.98 mm2) and left as 0–17.3 mm2 (4.93 mm2). There was not a difference in the areas of MF between the two sides. Furthermore, it was determined that ANOVA test and BMI, Pearson test with age and gender did not appear to have an effect on MF areas. Only within the obese people, left MF area was significantly different than those with other BMI groups. A negative effect on image quality was found statistically significantly correlated with age and MF. None of the investigated MFs were garbled by any of the investigated influence factors. Conclusion: In incidences in which the anatomical structure of the MF and the areas were crucial; age, gender, height, and weight of the individual were not determinant factors. BMI and MF appeared to have a negative impact.

A new design of CAD/CAM surgical template system for two-piece narrowing genioplasty

The purpose of this study was to develop and validate a new chin template system for a two-piece narrowing genioplasty. Nine patients with wide chin deformities were enrolled. Surgeries were planned with the computer-aided surgical simulation (CASS) planning method. Surgical splints and chin templates were designed in a computer and fabricated using a three-dimensional printing technique. The chin template system included a cutting guide and a repositioning guide for a two-piece narrowing genioplasty. These guides were also designed to avoid the mental foramen area and inferior alveolar nerve loops during the osteotomy, for nerve protection. After surgery, the outcome evaluation was completed by first superimposing the postoperative computed tomography model onto the planned model, and then measuring the differences between the planned and actual outcomes. All surgeries were completed successfully using the chin template system. No inferior alveolar nerve damage was seen in this study. With the use of the chin templates, the largest linear root mean square deviation (RMSD) between the planned and the postoperative chin segments was 0.7mm and the largest angular RMSD was 4.5°. The results showed that the chin template system provides a reliable method of transfer for two-piece osseous narrowing genioplasty planning.

Role of "major" and "minor" lambdoid arch sutures in posterior cranial fossa changes: mechanism of cerebellar tonsillar herniation in infants with multisutural craniosynostosis.

This study aimed to explain the functional role of lambdoid arch sutures in the development of cerebellar tonsillar herniation. Posterior cranial fossa (PCF) changes were investigated in infants with premature synostosis of the major and minor sutures of the lambdoid arch without premature synostosis of the PCF synchondroses. Morphometric and volumetric PCF measurements were performed on preoperative high-resolution CT studies in 12 infants with multisutural craniosynostosis involving the lambdoid arch and compared with those of 12 age-matched healthy subjects. All 12 patients had hypoplasia of PCF bone structures and normal volumes of the PCF and neural structures. PCF hypoplasia was related to exocciput length in infants with isolated involvement of major sutures, while it was related to posterior skull base hemifossae in infants with isolated involvement of minor lambdoid arch sutures. Foramen magnum AP diameter was reduced in babies with major suture involvement and tonsillar herniation, while foramen magnum AP and LL diameters were reduced in babies with minor suture involvement without tonsillar herniation. Right and left jugular foramen (JF) areas differed in all infants; however, the area of the smaller JF was significantly reduced only in infants with involvement of minor lambdoid arch sutures. Hypoplasia of PCF bone structures due to sutural synostosis of the lambdoid arch is a required predisposing but not sufficient factor for the development of cerebellar tonsillar herniation through the foramen magnum. Normal PCF volume and foramen magnum anatomy may partly explain the development of cerebellar tonsil herniation in infants with lambdoid arch synostosis.

Papillary meningioma of the jugular foramen: A case report.

Papillary meningioma (PM) is a rare histological variant of intracranial meningioma, which displays an aggressive behavior and its management is difficult. The present study reported the case of a 21-year-old male patient, who presented with headaches and dizziness. Upon neurological examination, left hypoglossal nerve palsy and left cerebellar signs were observed. Computed tomography and magnetic resonance imaging scans of the brain revealed a high-density mass in the left jugular foramen area. Following an uneventful complete surgical resection of the tumor, a definitive diagnosis of Grade III PM was determined based on the histopathological findings, according to the World Health Organization classification. CT scanning one day after surgery confirmed that the tumor had been completely resected, and after four years of follow-up, no evidence of transformation or recurrence was observed.

Evaluation of temperature values in mental foramen area in case of patients using removable partial dentures

The purpose of the research was an evaluation of removable partial dentures (RPDs) influence on temperature values registered in the area of mental foramen. Initial assumption was made that temperature is proportional to blood flow in mental artery. Additionally, the research objective was an assessment of application of infrared thermovision technique in the field of dental prosthodontics. Two independent groups of patients were examined. Test group consisted of 30 patients using RPD, and control group was composed of 33 patients partially edentulous in mandibular dental arch. The mean age in the test group was 68.8 years, standard deviation (SD) = 10.6, whereas in control group 62.3, SD = 11.9. Temperature values were recorded with thermovision camera. Test group patients underwent two examinations (with denture and 45 min after denture removal), and control group patients were examined once. Results showed decreased temperature values in case of test group patients. The differences were statistically significant (p < 0.05); however, the dentures negative influence was transient as 45 min after RPD removal temperature values were similar in both groups.

Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesis.

Extreme lateral interbody fusion provides minimally invasive treatment of spinal deformity, but complications including nerve and psoas muscle injury have been noted. To avoid nerve injury, mini-open anterior retroperitoneal lumbar interbody fusion methods using an approach between the aorta and psoas, such as oblique lumbar interbody fusion (OLIF) have been applied. OLIF with percutaneous pedicle screws without posterior decompression can indirectly decompress the spinal canal in lumbar degenerated spondylolisthesis. In the current study, we examined the radiographic and clinical efficacy of OLIF for lumbar degenerated spondylolisthesis. We assessed 20 patients with lumbar degenerated spondylolisthesis who underwent OLIF and percutaneous pedicle screw fixation without posterior laminectomy. MR and CT images and clinical symptoms were evaluated before and 6months after surgery. Cross sections of the spinal canal were evaluated with MRI, and disk height, cross-sectional areas of intervertebral foramina, and degree of upper vertebral slip were evaluated with CT. Clinical symptoms including low back pain, leg pain, and lower extremity numbness were evaluated using a visual analog scale and the Oswestry Disability Index before and 6months after surgery. After surgery, significant increases in axial and sagittal spinal canal diameter (12 and 32%), spinal canal area (19%), disk height (61%), and intervertebral foramen areas (21% on the right side, 39% on the left), and significant decrease of upper vertebral slip (-9%) were found (P<0.05). Low back pain, leg pain, and lower extremity numbness were significantly reduced compared with before surgery (P<0.05). Significant improvements in disk height and spinal canal area were found after surgery. Bulging of disks was reduced through correction, and stretching the yellow ligament may have decompressed the spinal canal. Lumbar anterolateral fusion without laminectomy may be useful for lumbar spondylolisthesis with back and leg symptoms.

Binary Logistic Regression Analysis of Foramen Magnum Dimensions for Sex Determination.

Purpose. The structural integrity of foramen magnum is usually preserved in fire accidents and explosions due to its resistant nature and secluded anatomical position and this study attempts to determine its sexing potential. Methods. The sagittal and transverse diameters and area of foramen magnum of seventy-two skulls (41 male and 31 female) from south Indian population were measured. The analysis was done using Student's t-test, linear correlation, histogram, Q-Q plot, and Binary Logistic Regression (BLR) to obtain a model for sex determination. The predicted probabilities of BLR were analysed using Receiver Operating Characteristic (ROC) curve. Result. BLR analysis and ROC curve revealed that the predictability of the dimensions in sexing the crania was 69.6% for sagittal diameter, 66.4% for transverse diameter, and 70.3% for area of foramen. Conclusion. The sexual dimorphism of foramen magnum dimensions is established. However, due to considerable overlapping of male and female values, it is unwise to singularly rely on the foramen measurements. However, considering the high sex predictability percentage of its dimensions in the present study and the studies preceding it, the foramen measurements can be used to supplement other sexing evidence available so as to precisely ascertain the sex of the skeleton.

Cyclophosphamide-Induced Morphological Changes in Dental Root Development of ICR Mice.

BackgroundSurvivors of childhood cancer are at risk of late dental development. Cyclophosphamide is one of the most commonly used chemotherapeutic agents against cancer in children. The aim of this study was to investigate the effects of cyclophosphamide on root formation in the molars of growing mice and to assess the morphological changes in these roots using three-dimensional structural images.MethodsWe treated 16 12-day-old ICR mice with cyclophosphamide (100 mg/kg, i.p.) and 16 control mice with saline. At 16, 20, 24, and 27 days of age, the mandibular left first molars were scanned using soft micro-computed tomography. After scanning, the structural indices were calculated using a three-dimensional image analysis system, and the images were subjected to three-dimensional reconstruction. The length and apical foramen area of all distal roots were assessed. Histological changes in the apical region were then assessed via hematoxylin and eosin staining.ResultsThe mandibular molars of all experimental mice showed evidence of cytotoxic injury, which appeared in the form of anomalous root shapes. Although all roots developed further after cyclophosphamide injection, the three-dimensional structural images showed that the roots in the experimental group tended to develop more slowly and were shorter than those in the control group. At 27 days of age, the mean root length was shorter in the experimental group than in the control group. Conversely, the apical foramen of the roots in the experimental group tended to close faster than that of roots in the control group. In addition, hematoxylin and eosin staining of the distal roots in the experimental group showed increased dentin thickness in the apical region.ConclusionOur results suggest that cyclophosphamide can result in short root lengths and early apical foramen closure, eventually leading to V-shaped or thin roots.

In vivo dynamic changes of dimensions in the lumbar intervertebral foramen

Background contextPrevious studies have reported position-dependent changes of the lumbar intervertebral foramen (LIVF) dimensions at different static flexion-extension postures. However, the changes of the LIVF dimensions during dynamic body motion have not been reported. PurposeThe objective of this study was to investigate the in vivo dimensions of the LIVF during a dynamic weight-lifting activity. Study design/SettingThis was a retrospective study. MethodsTen asymptomatic subjects were recruited for this study. Three-dimensional (3D) vertebral models of the lumbar segments from L2 to S1 were constructed for each subject using magnetic resonance images. The lumbar spine was then imaged using a dual fluoroscopic imaging system as the subject performed a dynamic weight-lifting activity from an upper body position of 45° to a maximal extension position. The in vivo positions of the vertebrae along the motion path were reproduced using the 3D vertebral models and the fluoroscopic images. The minimal area, height, and width of each LIVF during the dynamic body motion were analyzed. ResultsThe LIVF area and width monotonically decreased with lumbar extension at all levels except L5–S1 (p<.05). On average, the LIVF area decreased by 7.4±6.7%, 10.8±7.7%, and 10.0±8.0% at the L2–L3, L3–L4, and L4–L5 levels, respectively, from the flexion to the upright standing position, and by 6.4±5.0%, 7.7±7.4%, and 5.1±5.1%, respectively, from the upright standing to the extension position. The LIVF height remained relatively constant at all segments during the dynamic activity. The foramen area, height, and width of the L5–S1 remained relatively constant throughout the activity. ConclusionsHuman lumbar foramen dimensions show segment-dependent characteristics during the dynamic weight-lifting activity.

Skull Base Morphology in Fibroblast Growth Factor Receptor Type 2-Related Faciocraniosynostosis

Children with faciocraniosynostosis present skull base abnormalities and may develop hydrocephalus or cerebellar tonsils ectopia (CTE). Several pathophysiological hypotheses were formulated in the past decades to explain these associations. However, no study has described in a genetically homogeneous population with confirmed fibroblast growth factor receptor type 2 (FGFR2) mutation eventual correlations between skull base abnormalities and hydrocephalus or CTE. To illustrate these features in children <2 years of age with a genetically confirmed FGFR2-related faciocraniosynostosis. We measured the foramen magnum area (FMA) and its sagittal and transversal components: the right, left, and mean area of the jugular foramen; the posterior fossa volume; and the cerebellar volume on preoperative millimetric computed tomography scan slices in 31 children with an FGFR2 mutation (14 with Crouzon syndrome, 11 with Apert syndrome, and 6 with Pfeiffer syndrome). They were compared with 17 children without synostosis. All children were <24 months of age. We correlated all these measures with the presence of hydrocephalus or CTE. We observed a significantly small FMA in children with Crouzon (P = .03) and in children with Pfeiffer (P = .05) resulting from a reduced sagittal diameter (P = .02 for Crouzon and P = .002 for Pfeiffer). Hydrocephalus was associated with small FMA (P = .02). The jugular foramen area, posterior fossa volume, and cerebellar volume were not associated with hydrocephalus or CTE. Hydrocephalus and CTE were statistically associated (P = .002). Hydrocephalus in FGFR2-related Crouzon and Pfeiffer syndromes is statistically associated with a small FMA. Hydrocephalus is statistically associated with CTE.

Stellate Ganglion Block, Compared With Xenon Light Irradiation, Is a More Effective Treatment of Neurosensory Deficits Resulting From Orthognathic Surgery, as Measured by Current Perception Threshold

The aim of this study was to evaluate the relative effectiveness of stellate ganglion blockade (SGB) versus xenon light irradiation (XLI) for the treatment of neurosensory deficits resulting from orthognathic surgery as determined by a comparison of prospective measurements of electrical current perception thresholds (CPTs) and ranged CPTs (R-CPTs). CPT and R-CPT in the mental foramen area were measured during electrical stimulation at 98 different sites on the body in patients who had undergone orthognathic surgery. After surgery, patients were assigned to the SGB group or the XLI group. CPT and R-CPT of the 2 groups were measured at stimulation frequencies of 2,000, 250, and 5 Hz before surgery, 1 week after surgery, and after 10 treatment sessions. Furthermore, the influence of surgical factors, such as genioplasty and a surgically exposed inferior alveolar nerve (IAN), was examined in the 2 groups. Patients' CPT and R-CPT values indicated a considerable amount of sensory disturbance in most cases after surgery. The change in magnitude of all CPT and R-CPT values for the SGB group decreased considerably compared with that for the XLI group after treatment. There was no correlation between CPT or R-CPT values and surgical factors (eg, genioplasty and exposure of the IAN). SGB of the IAN could be an effective method for treating neurosensory deficits after orthognathic surgery on the IAN.

Normal anatomy and anatomic variants of vascular foramens in the cervical vertebrae: a paleo-osteological study and review of the literature.

We investigated 923 cervical vertebrae belonging to late-antiquity and medieval skeletal remains and assessed the qualitative and quantitative structural characteristics of transverse foramens (TF) and additional vascular canals. We also reviewed the pertinent literature. Double TF were chiefly observed in C6 (with a right/left side prevalence of 35.7 and 44.4%, respectively) and C5 vertebrae (23.6 and 23.9%, right/left side, respectively), while unclosed TF were mainly documented in C1 vertebrae (8.4%). Retrotransverse canal and retrotransverse groove were present in 8.5 and 17.8%, respectively, of C1 vertebrae examined, while arcuate foramens and supertransverse foramens were found in 7.3 and 3.7% of specimens, respectively. TF diameter decreased from C6 to C2 vertebrae, being smallest in C7 and greatest in C1 vertebrae, with no left/right significant difference. There was a significant correlation between TF diameter and stature, but only on the right side. The mean area of the arcuate foramen was lower than the mean area of the ipsilateral TF (24.5 ± 5.7 vs 28.5 ± 7.7 mm(2), respectively; p = 0.048), possibly causing compression of the vertebral artery within the arcuate foramen. The study of human vertebrae excavated from archaeological sites is a simple and effective way to analyze the morphology and quantitative anatomy of vascular foramens.

Tubular adenoid cystic carcinoma of palate: A rare case report

Adenoid cystic carcinoma (ACC) is a rare malignant tumor that affects the major and minor salivary glands, the lacrimal glands, the ceruminous glands and occasionally the excretory glands of the female genital tract. 30-40% of these carcinomas occur in the head and neck region. Approximately 50-70% of the cases have been reported in the minor salivary glands. The most common location is the palate, generally in the area of the greater palatine foramen. ACC is generally characterized by a slow growth rate, and it is often present for several years before the patient seeks treatment. Here we present a case of 42-year-old female who came to the department for the complaint of a swelling over the right side of palate since 2-3 months which was diagnosed as a benign tumor initially, but was confirmed as tubular ACC histologically.

Management of Tooth and Observation of External Root Surface with Extrusion of Calcium Hydroxide-Containing Paste

Introduction: Extrusion of the root canal filling materials is often absorbed and heals, which produces no irreversible changes. However, sometimes it causes the persisting pain and apical radiolucent. This case shows that extrusion of calcium hydroxide [Ca(OH)2] intracanal medicament caused the persistent percussion pain. Methods: This case report describes the patient with extrusion of Ca(OH)2 into the periapical tissue in the mandibular right second premolar. A 48-year-old female presented with persistent occlusal pain. Radiographs revealed a radiolucent lesion in the periapical region of mandibular second premolar. The cone-beam computed tomography scan revealed the non-radiolucency root canal materials around the root apex and periapical radiolucency was present along with considerable external root resorption. After preparation, root canal was filled with gutta-percha cones and root canal sealer, and intentional replantation with apicoectomy was performed. The resected portion of root apex was observed by stereomicroscopy and scanning electron microscopy (SEM). Results: The root surface contacted with Ca(OH)2 paste was observed by stereomicroscopy. SEM observation revealed that the area of the apical foramen was covered with the complex of the extended materials and resorption of apex was observed. At the 1-month recall appointment, the patient presented asymptomatically without tooth mobility. Five months after the surgery, radiograph showed new bone formation around periapical region. The patient had no clinical symptoms of pain. Conclusions: The treatment had been successful, achieving adequate repair with 9 months of follow-up. Appropriate size of the apical foramen was essential for success of the root canal treatment. Extrusion of Ca(OH)2 paste caused persistent occlusal pain and the apical foramen coverage by the materials.

A Clinical Investigation of Contralateral Neurological Symptom after Transforaminal Lumbar Interbody Fusion (TLIF).

BackgroundThe aim of this study was to analyze treatment outcomes and morbidity of contralateral neurological symptom in patients after TLIF surgery and to explore its possible causes.Material/MethodsA retrospective study was conducted involving a total of 476 patients who underwent TILF from 2009 to 2012 in our hospital. These cases were divided into a symptomatic group (Group S) and a non-symptomatic group. The differences in contralateral foramen area and disc-height index(DHI) before and after surgery were compared between Group S and a random sample of 40 cases of non-symptomatic group patients (group N). In addition, according to whether the patient underwent second surgery, Group S patients were further divided into a transient neurologic symptoms group (Group T) and an operations exploration group (Group O). The time of symptom appearance, duration, and symptomatic severity (JOA VAS score) were compared between Group T and O.ResultsAmong the 476 patients, 18 had postoperative contralateral neurological symptoms; thus, the morbidity was 3.7815%. The indicators in Group S were lower than in Group N in the differences in contralateral foramen area and disc-height index(DHI) before and after surgery (p<0.05). Five patients (Group O) in Group S had second surgery because of invalid conservative treatment. The surgical exploration rate was 1.0504%. Compared with Group T, the symptoms of Group O patients appeared earlier, persisted longer, and were more serious (p<0.05).ConclusionsContralateral neurological symptom is a potential complication after TLIF, and its causes are diverse. Surgical explorations should be conducted early for those patients with the complication who present with obvious nerve damage.

The interpretive power of infraorbital foramen area in making dietary inferences in extant apes.

The infraorbital foramen (IOF) is located below the orbit and transmits the sensory infraorbital nerve (ION) to mechanoreceptors located throughout the maxillary region. The size of the IOF correlates with the size of the ION; thus, the IOF appears to indicate relative touch sensitivity of maxillary region. In primates, IOF size correlates well with diet. Frugivores have relatively larger IOFs than folivores or insectivores because fruit handling/processing requires increased touch sensitivity. However, it is unknown if the IOF can be used to detect subtle dietary differences among closely related hominoid species. Hominoids are traditionally grouped into broad dietary categories, despite the fact that hominoid diets are remarkably diverse. This study examines whether relative IOF size is capable of differentiating among the dietary preferences of closely related species with overlapping, yet divergent diets. We measured IOF area in Hylobates lar, Symphalangus syndactulus, Pongo pygmaeus spp., Pan troglodytes, Gorilla gorilla, Gorilla beringei graueri, and Gorilla beringei beringei. We classified each species as a dedicated folivore, mixed folivore/frugivore, soft object frugivore, or hard object frugivore. The IOF is documented to be larger in more frugivorous species and smaller in more folivorous taxa. Interestingly, G.b. beringei, had the largest relative IOF of any gorilla, despite being a dedicated folivore. G.b. beringei does have unique food processing behavior that relies heavily on maxillary mechanoreception, thus this finding is not entirely unsupported behaviorally. The results of this study provide evidence that the IOF is an informative feature in interpretations of fossil apes.