Vertebral Fusion Research Articles

First abnormalities investigation in Mullus barbatus (Mullidae) from the Eastern Coast of Algeria

Red mullet Mullus barbatus, Linnaeus, 1758, is a benthic marine fish. Because of its wide geographic distribution and close association with sediments, red mullet is commonly used as a sentinel species for pollution assessment along the Mediterranean coast. A total of 500 specimens were examined from the Gulf of Bejaia, eastern coast of Algeria, from June 2018 to June 2019 by X-ray radiography and histopathological examination. We observed for the first time in Algeria complex spinal column deformities (kyphosis, lordosis, and scoliosis), vertebral coalescence, vertebral fusion, missing of one pelvic fin, caudal fin abnormalities, congested cheek, lymphocystis, ovary malformation, and asymmetric testis. Additionally, fibrosis, inflammatory reaction, melano-macrophage centres, necrosis, atresia, and disturbance of normal tissue were detected by histopathology examination

RUnT: A Network Combining Residual U-Net and Transformer for Vertebral Edge Feature Fusion Constrained Spine CT Image Segmentation

RUnT: A Network Combining Residual U-Net and Transformer for Vertebral Edge Feature Fusion Constrained Spine CT Image Segmentation

Lower lumbar vertebrae replacement by FEA based assessment of suitable ceramic polymer composites

Using bio-materials to develop a safe, secure, and prime substitute as an external entity to interact inside a human environment is a demanding area of research and expertise. The lumbar spine is the most common site for injury in the spinal column as it bears the majority of the human body’s weight while also undergoing significant prolonged loading and stress. In the same direction, a cost-effective Artificial Lumbar vertebra is designed and recognized to be implanted in the spinal region of a body to replace injured or disfigured counterparts. By harnessing the power of 3D bioprinting, biomaterials, and FEA, the paper proves that a simple bio-printed flexible lumbar vertebrae can be integrated into the body to work in conjunction with the rest of the spinal cord just as any other of the vertebrae do, thereby working in coordination with humans. The material thus obtained will be capable of replacing the injuries in the vertebrae caused by mechanical failures like compressive loading, vertebral slip, or vertebral joint fusion. An overall lightweight structure consisting of a firm material is looked forward to for the paper’s fusion. This insight, research, and design have led to the development of the research paper.

The Thoracoscopic Approach in Spinal Cord Disease.

Most VATS approaches are from the right side for pathologies involving the middle and upper thoracic spine because there is a greater working spinal surface area lateral to the azygos vein than that lateral to the aorta. Below T-9, a left-sided approach is made possible because the aorta moves away from the left posterolateral aspect of the spine to an anterior position as it passes through the diaphragm. VATS has been used extensively in spinal deformities such as scoliosis. The use of VATS in spine surgery includes the treatment of thoracic prolapsed disk diseases, vertebral osteomyelitis, fracture management, vertebral interbody fusion, tissue biopsy, anterior spinal release, and fusion without or with instrumentation (VAT-I) for spinal deformity correction. As the knowledge and the comfort of using such techniques have expanded, the indications have extended to corpectomy for tumor resections. In the field of minimally invasive surgery, VATS now acts as a keyhole to the thoracic spine and an alternative to open thoracotomy for the treatment of several spinal conditions.Although VATS can be performed in such spine conditions, it is most beneficial in the treatment of scoliotic deformity, which requires taking a multilevel approach, from the upper to the lower thoracic spine.

A New Interlaminar/Interspinous and Facet-Joint Stabilization System in Lumbar Degenerative Disk Disease: 2Years of Results.

In lumbar degenerative disk diseases (DDDs), we include a wide range of lumbar pathologies. Lumbar spinal stenosis with or without spondylolisthesis is a common cause of lower-limb pain in elderly patients. The surgical treatment of lumbar DDD consists of the decompression of the neural structures or the decompression and fusion of the involved motion segment. Unfortunately, rigid spinal implants followed by fusion cause increased stresses on the neighboring spinal segments, often leading to adjacent segment degeneration. The aim of this paper is to present a new system for interlaminar/interspinous and facet-joint stabilization and fusion. From March 2018 to June 2021, 175 patients with severe lumbar back and/or leg pain were operated on with this device after the failure of conservative treatment for a minimum of 6months. For this study, we considered 75 available patients with a minimum follow-up time of 24months. Patients rated their back pain and leg pain on a visual analog scale (VAS) after surgery and at the last follow-up; also, the postoperative consumption of analgesic drugs was investigated. Finally, patients were asked whether they would undergo this kind of surgery again or recommend it. The device is designed to promote a better and more efficient intervertebral fusion: Bone Ingrowth technology allows the system to achieve the best response from the bone tissue. All procedures were performed without any complications. A reoperation was required in five cases (6.7%) because of implant failure. In one case, a spinous process and unilateral articular process fracture occurred. In four cases, a subcutaneous ISCHIA (one case) or FILICUDI (three cases) pullout was observed. Significant improvements following lumbar surgery were observed when evaluating the postoperative VAS values, analgesic drug consumption levels, and patients' satisfaction ratings. Evident fusion was seen in 58 of 75 patients (77.3%). Our interspinous/interlaminar and facet-joint implant solution, associated with bone grafting, provided vertebral fusion in most stenotic patients with Grade I DS undergoing bilateral microdecompression (BMD) or bilateral decompression via the unilateral approach (BDUA). A higher number of patients and a longer follow-up will certainly be required to completely validate these new devices, but this minimally invasive surgery (MIS) is currently very encouraging and satisfactory.

Comparing oblique lumbar interbody fusion with lateral screw fixation and percutaneous endoscopic transforaminal discectomy (OLIF-PETD) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of lumbar disc herniation complicated with lumbar instability

ObjectiveTo evaluate the early clinical effect of oblique lumbar interbody fusion with lateral screw fixation and percutaneous endoscopic transforaminal discectomy (OLIF-PETD) in the treatment of lumbar disc herniation with lumbar instability.MethodsA total of 22 patients with lumbar disc herniation and lumbar instability from August 2017 to August 2019 were enrolled in this retrospective study. The general information, perioperative indicators and complications were recorded. The clinical outcomes and radiological outcomes were evaluated before the operation, seven days after the operation, and at the last follow-up. Vertebral fusion and degree of multifidus muscle injury were evaluated at the last follow-up.ResultsIn this study, OLIF + PETD showed shorter incision length compared to the MIS-TLIF (P < 0.001). In the two groups, the clinical outcomes and radiological outcomes were significantly improved compared with the preoperative (P < 0.001). At the seven days after the operation and the last follow-up, the VAS of OLIF + PETD group was lower than that of MIS-TLIF group (P < 0.05). OLIF + PETD could give superior outcome in restoring disc height (P < 0.001), but the fusion segment angle of OLIF + PETD group was larger compared to the MIS-TLIF group seven days after the operation and at the last follow-up (P < 0.05). In addition, the fusion rate was not significantly different between the two groups (P > 0.05), but OLIF + PETD could avoid the multifidus injury (P < 0.001).ConclusionCompared to MIS-TLIF, OLIF-PETD can achieve satisfactory decompression effects and fusion rates with less multifidus injury and postoperative low back pain, which may be an alternative choice for the treatment of lumbar disc herniation combined with lumbar instability.

Effect of different fixation methods on biomechanical property of cervical vertebral body replacement and fusion

BackgroundThe main purpose of this study was to examine the effect of different fixation methods (anterior fixation, self-stabilizing fixation and anterior-posterior fixation) on biomechanical property of vertebral body replacement and fusion. MethodsThree finite element models of cervical vertebral body replacement and fusion were established. The implanted models included artificial vertebral body and fixation system, and the loads imposed on the models included 75 N compression load and 1 Nm moment load. FindingsFor anterior-posterior fixation, the cervical load was mainly transmitted by the posterior pedicle screw and rod (more than 50%), and the stress shielding problem was the most significant than the self-stabilizing and anterior fixation. Self-stabilizing fixation was more helpful to the fusion of implant and vertebrae, but the higher risk of vertebral body collapse was worthy of attention if the cervical spine with osteoporosis. The stress of bone was mainly concentrated around the screw hole. The maximum stress (20.03 MPa) was lower than the yield stress of cortical bone and the possibility of fracture around the fixation device of cervical spine was low. The anterior fixation could meet the requirement of vertebral body replacement and fusion, and the addition of posterior pedicle screws and rods might obtain better treatment in cases of severe spine injury or osteoporosis. InterpretationThe findings of this study may provide guidance on clinical treatments for choosing more appropriate fixation methods for different patients.

Novel FLNB Variants in Seven Argentinian Cases with Spondylocarpotarsal Synostosis Syndrome.

Spondylocarpotarsal synostosis syndrome (SCT) is a very rare skeletal dysplasia characterized by vertebral, carpal, and tarsal fusion; growth retardation; and mild dysmorphic facial features. Variants in FLNB, MYH3, and RFLNA have been implicated in this dysplasia. We report the clinical and radiological follow-up of seven SCT pediatric cases associated with biallelic FLNB variants, from four Argentinian families. The seven cases share previously described facial characteristics: round facies, large eyes, and wide based nose; all of them had variable height deficit, in one case noted early in life. Other findings included clinodactyly, joint limitation without bone fusion, neurosensorial hearing loss, and ophthalmological compromise. All cases presented with spinal fusion with variable severity and location, carpal bones coalition, and also delay in carpal ossification. The heterozygous carrier parents had normal height values to -2.5 score standard deviation, without skeletal defects detected. Three different FLNB variants, one nonsense and two frameshift, were detected, all of which were predicted to result in a truncated protein or are degraded by nonsense mediated decay. All cases had at least one copy of the nonsense variant, c.1128C> G; p. (Tyr376*), suggesting the presence of a common ancestor.

Truly dorsostable runners: Vertebral mobility in rhinoceroses, tapirs, and horses.

The vertebral column is a hallmark of vertebrates; it is the structural basis of their body and the locomotor apparatus in particular. Locomotion of any vertebrate animal in its typical habitat is directly associated with functional adaptations of its vertebrae. This study is the first large-scale analysis of mobility throughout the presacral region of the vertebral column covering a majority of extant odd-toed ungulates from 6 genera and 15 species. In this study, we used a previously developed osteometry-based method to calculate available range of motion. We quantified all three directions of intervertebral mobility: sagittal bending (SB), lateral bending (LB), and axial rotation (AR). The cervical region in perissodactyls was found to be the most mobile region of the presacral vertebral column in LB and SB. Rhinoceroses and tapirs are characterized by the least mobile necks in SB among odd-toed and even-toed ungulates. Equidae are characterized by very mobile necks, especially in LB. The first intrathoracic joint (T1-T2) in Equidae and Tapiridae is characterized by significantly increased mobility in the sagittal plane compared to the typical thoracic joints and is only slightly less mobile than typical cervical joints. The thoracolumbar part of the vertebral column in odd-toed ungulates is very stiff. Perissodactyls are characterized by frequent fusions of vertebrae with each other with complete loss of mobility. The posterior half of the thoracic region in perissodactyls is characterized by especially stiff intervertebral joints in the SB direction. This is probably associated with hindgut fermentation in perissodactyls: the sagittal stiffness of the posterior thoracic region of the vertebral column is able to passively support the hindgut heavily loaded with roughage. Horses are known as a prime example of a dorsostable galloper among mammals. However, based on SB in the lumbosacral part of the backbone, equids appear to be the least dorsostable among extant perissodactyls; the cumulative SB in equids and tapirs is as low as in the largest representatives of artiodactyls, while in Rhinocerotidae it is even lower representing the minimum across all odd-toed and even-toed ungulates. Morphological features of small Paleogene ancestors of rhinoceroses and equids indicate that dorsostability is a derived feature of perissodactyls and evolved convergently in the three extant families.

Characteristics of the psoas minor muscle in modeling lateral interbody spondylodesis of the lumbar spine

ВACKGROUND: For the treatment of degenerative diseases of the spine, various deformities, a minimally invasive technique of lateral lumbar interbody fusion is used, which minimizes the risks of spinal cord injury. In the development of these pathologies, the most important role is assigned to the paraspinal muscles, the histological features of which are insufficiently elucidated in the relevant literature when modeling spondylodesis.&#x0D; АIM: To investigate the effect of lateral interbody vertebral fusion (spondylodesis) when introducing titanium implants on the histostructure of the psoas minor muscle.&#x0D; МATERIALS AND METHODS: Experiments were performed in 14 mongrel dogs, 3 individuals the control group (norm). The аnimals underwent discectomy at the level of L45, L56 vertebrae through the lateral approach on the right, and interbody titanium implants were installed. The lumbar spine was stabilized with an external fixator for 30 days. Paraffin muscle sections were stained with hematoxylin-eosin, according to Masson.&#x0D; RESULTS: During the experiment, an increased variety of myosymplast diameters, loss of polygonality of their profiles, fibrosis of the interstitial space, and sclerotization of the vascular membranes were observed in the psoas minor muscle. The volume density of endomysium in both muscles increased 1.5 times relative to the norm after 6 months Other parameters decreased: the volume of myosymplasts was 95%, that of microvessels 73% on the left, 83% on the right. On the other hand, the degree of fatty infiltration increased, amounting to 276% on the left and 394% on the right of the normal parameters. After 18 months, the bulk density of muscle fibers on the left was restored to the value in the control, on the right it was only 95%. The degree of sclerotization in the muscle on the left is 133%, on the right 161% of the norm; the index of fatty infiltration was 146% on the left and 339% on the right of the normal parameter.&#x0D; CONCLUSION: pathohistological changes in the psoas minor during lateral interbody fusion are more pronounced on the side of the operative approach, which necessitates minimizing trauma to the paravertebral muscles during operations in order to prevent sclerotization and fatty involution of muscle tissue.

KLIPPEL-FEIL SYNDROME

Introduction Klippel-Feil Syndrome is a complex condition, characterized by fusion of cervical vertebrae 2 and 3; however, it has been shown in several studies that fusion of the vertebrae also affects different cervical vertebrae. It is caused by a failure of the normal division or segmentation of the cervical vertebrae in early fetal development. This anatomical variant can lead to chronic headaches, limitation of neck movement and pain in the neck muscles. In addition, it may manifest neurological symptomatology (1)(2). The aim of this literature review is to consider this malformation as one of the main differential diagnoses in patients who present neurological symptoms or a history of trauma; since, as has been shown, the presence of this malformation can be confused with the presence of a cervical fracture; therefore, patients who present with clinical or imaging alterations need to be carefully evaluated to confirm or rule out the presence of this pathology. Conclusions Klippel-Feil, being a very rare pathology, is often forgotten, so the doctor must remember the most important clinical-epidemiological characteristics, since this pathology can be considered as a differential diagnosis in patients with a pathological condition located in the cervical region; in addition, this pathology should be considered when the patient has systemic pathologies, especially of the renal type. KEY WORDS: Klippel-Feil syndrome, cervical spine, congenital spinal fusion, radiological abnormalities.

Effect of Teriparatide Versus Zoledronate on Posterior Lumbar Interbody Fusion in Postmenopausal Women with Osteoporosis

We evaluated the efficacy of teriparatide versus zoledronate on spinal fusion in osteoporotic patients after posterior lumbar interbody fusion (PLIF). Postmenopausal women with osteoporosis undergoing PLIF for degenerative spondylolisthesis were randomly assigned to receive either zoledronate or teriparatide. During the 2-year follow-up period, serial radiographs were used to determine fusion status and instrumentation-related sequelae (a composite of adjacent vertebral compressive fracture, instrumentation failure, and fusion failure). The bone mineral density (BMD) and Oswestry disability index (ODI) were also serially measured. Of the 77 patients, 36 were in the teriparatide group and 41 in the zoledronate group and had completed the 2-year follow-up assessments. Bony union had been achieved more frequently in the teriparatide group than in the zoledronate group at 6 months postoperatively (P < 0.05), although the overall rate of bone union was comparable between the 2 groups. The incidence of instrumentation-related sequelae was also comparable between the 2 groups (teriparatide vs. zoledronate group, 13.9% vs. 22.0%). Regarding antiosteoporosis, the BMD values had significantly improved in both groups at the last follow-up. The teriparatide group had attained more BMD increments at 12 months postoperatively than had the zoledronate group. Furthermore, the ODI had consistently decreased in both groups with a lower ODI in the teriparatide group than in the zoledronate group at 12 months postoperatively. Among postmenopausal women with osteoporosis, teriparatide showed superior bone union at 6 months and greater BMD improvement at 12 months after PLIF compared with zoledronate administration, although both resulted in similar overall effects on spinal fusion.

Patient-specific numerical investigation of the correction of cervical kyphotic deformity based on a retrospective clinical case

Little research has been reported on evaluating the safety of the fixation construct in cervical kyphosis correction. In this study, we proposed a principal-strain criterion to evaluate the safety of the fixation construct and validated the modeling method against a retrospective case of anterior cervical discectomy fusion (ACDF). From C2 to T2 vertebra bodies, fixation instruments were reconstructed and positioned as per postoperative computed tomography (CT) scans. Head weight (HW) and various moments estimated from isometric strength data were imposed onto the C2. The postoperative stability of non-surgical segments, deformations surrounding the screw trajectories, and contact slipping on zygapophysial joints were analyzed. The model was validated against the reality that the patient had a good fusion and deformity correction. The ACDF restricted the range of motions (ROMs) of cervical segments and lent stability to vertebra fusion, no failure was found in the finite element (FE) model of cervical vertebrae. The deformation surrounding the screw trajectories were concentrated to the lateral sides of trajectories, recommending that the shape of the anterior cervical plate conforming to the curvature of the vertebra and screws fully inserted into vertebrae reduced the deformation concentration around the screw trajectories.

8. Controlling the rate of presentation of BMP-2 from a highly structured composite for interbody fusion

<h3>BACKGROUND CONTEXT</h3> Clinical outcomes for patients with intervertebral disc injury or disease could be enhanced by a new generation of regenerative matrices that create tissue environments to control angiogenesis, chondrogenesis and bone formation. Regenerative matrices are a new class of controlled release biomaterials that use surface chemistry, materials architecture, and drug delivery kinetics to create optimised conditions for cell interactions that result in high quality tissue formation. A novel biodegradable polymer matrix that releases bone morphogenetic protein 2 (BMP-2) over a period of one month with a low Cmax and sustained presentation of active protein is investigated in this study. <h3>PURPOSE</h3> BMP-2 release kinetics and protein activity from a new regenerative matrix was quantified to develop an implant with 1-month release of the drug within a macroporous matrix. A rabbit posterolateral (PLF) vertebral fusion model was performed to assess bone formation and fusion outcomes as a function of dose and source of BMP-2 (E coli and CHO cells). <h3>STUDY DESIGN/SETTING</h3> The study was designed to investigate the effect of various biomaterial design factors and manufacturing methods on the rate of release of BMP-2, the activity of BMP-2 and the extent of in vivo bone formation. <h3>PATIENT SAMPLE</h3> This study did not involve patients. <h3>OUTCOME MEASURES</h3> Outcome measures were the mechanical properties of the regenerative matrix, the architecture and porosity of the matrix, BMP-2 release kinetics, BMP-2 activity as a function of release time and bone formation. <h3>METHODS</h3> BMP-2 activity was tested using two in vitro cell-based assays. BMP-2 solutions and regenerative matrix extracts were tested for their ability to induce alkaline phosphatase (ALP) activity in W-20-17 stromal cells using a modified version of the ASTM standard protocol for in vitro biological activity of recombinant human BMP-2 (F2131-02). Cells were exposed to serial dilutions of BMP-2 for 24 h, assayed for ALP activity and EC50s calculated allowing the relative potency to NIBSC WHO BMP-2 standard to be calculated. BMP-2 release was assessed with an in vitro assay of ALP activity in the mouse muscle myoblast cell line C2C12. Formulations were suspended above a C2C12 monolayer in an insert with a porous (8 µm) PET membrane. Following 3-4 days of exposure, the inserts containing LDGraft were transferred to fresh cells for a further 3-4 days. Cells exposed to LDGraft in this manner were assayed for ALP activity (normalised to protein content) once the inserts had been transferred to fresh cells. Fusion rate and new bone formation were compared to INFUSE in a single-level lumbar (L4-L5) posterolateral (PLF) vertebral fusion model in the New Zealand White rabbit based on standard protocols (Boden et al, 1995, ASTM F3207). Pre-formed implants (3 cc) of INFUSE (rhBMP-2 and absorbable collagen sponge) were implanted on decorticated dorsal surfaces of the transverse processes of L4 and L5 adjacent to the laminae. Fusion was assessed by radiograph at 6 weeks and by manual palpation, radiography and microCT at 12 weeks. <h3>RESULTS</h3> BMP-2 activity was retained over one month of release with the addition of protectants in the formulation and precise control of manufacturing processes. The matrix had a porosity of >70% with a high proportion of macropores (>200 micron diameter). Low doses of E. coli-produced BMP-2 induced fusion in the PLF model. <h3>CONCLUSIONS</h3> A one-month releasing BMP-2 formulation is described. This new regenerative matrix had internal architecture designed to host angiogenesis. Manufacturing and design challenges can be overcome to retain high biologic activity throughout the release period. <h3>FDA DEVICE/DRUG STATUS</h3> BMP-2, not approved for this indication.

Whose team do you ski for? The simultaneous presence of Klippel-Feil syndrome and diffuse idiopathic hyperostosis mimics clinical presentation of advanced ankylosing spondylitis.

Introduction: Klippel-Feil syndrome (KFS) is a congenital fusion of two or more cervical vertebrae. Diffuse idiopathic hyperostosis (DISH) is a disorder in which there is calcification of ligaments and tendons, primarily of the spinal column. The simultaneous occurrence of DISH and ankylosing spondylitis (AS) has seldom been described in the literature. Coexistence of KFS and DISH clinically resembling “skier’s posture” of the advanced AS, to the best of our knowledge has never been described before in literature. Case Report: 59-years old male was examined by rheumatologist due to inflammatory back pain and prolonged morning stiffness in spinal joints. He had “skier’s posture” which could be clinical sign of advanced axial disease in AS. Functional measurements had also spoken in favor of spondyloarthropathy. Spinal joints radiography described 2nd and 3rd cervical vertebral fusion along with prominent osteophytes and dorsal spine hyperostosis. Sacroiliac joints had no inflammatory or degenerative radiographic changes. Hip joints ultrasound excluded synovitis and effusion. Conclusion: Patient has two joint diseases, resulting in severe spinal degenerative changes, together resembling clinical presentation of advanced AS.

Klippel-Feil Syndrome: morphological findings in a 19th-century musealized skull from Viana del Bollo (Orense, Spain)

The aim of this study is to show the cranial alterations that Klippel-Feil syndrome produced in a case older than 200 years. Few paleopathological case studies diagnosed as Klippel-Feil Syndrome are focused on cranial abnormalities. A skull numbered 778, belonging to the Federico Olóriz Aguilera collection (Spain, 19th century AD), Universidad Complutense de Madrid, belonging to a young man born in a town in the North of Spain, was investigated. This cranium was visually inspected, hence macroscopically and paleoradiologically studied, using the images obtained through conventional radiology and CT scan imaging. In addition to the vertebral fusion between the atlas (C1) and the axis (C2), atlanto-occipital fusion, basilar impression, obliteration of the sagittal suture, enlarged parietal foramina and significant craniofacial asymmetry affecting maxillary bones, sphenoid, orbits, nasal bones and both palatines were observed. Morphological findings make it possible to diagnose a Klippel-Feil syndrome, possibly type-II, although the lack of the rest of the spinal column renders it impossible to verify other spinal anomalies. As a limitation, only the cranium and two cervical vertebrae were preserved, hence the possible involvement of the rest of the skeleton cannot be verified.

A rare lysosomal storage disorder: Feline mucopolysaccharidosis VII

AbstractA 9‐week‐old, male domestic shorthair presented with a 2‐week history of progressive hindlimb weakness and reduction in normal play behaviour. At 17 weeks of age, the patient exhibited progressive hindlimb paresis and ataxia and had developed facial dysmorphia and bilateral corneal clouding, prompting investigation into a mucopolysaccharidosis disorder. Peripheral blood cytology, increased urinary glycosaminoglycan excretion and radiographic findings (generalised epiphyseal dysplasia, coxofemoral luxation and vertebral fusion) suggested mucopolysaccharidosis. Definitive diagnosis was obtained through serum enzymatic testing, which yielded a complete deficiency in β‐glucuronidase and increased compensatory activity in α‐L‐iduronidase and B‐arylsulfatase. This pattern was consistent with a diagnosis of feline mucopolysaccharidosis VII, and palliative therapy was initially implemented. The patient ultimately died at 21 months of age.

Survival of an Indian Ocean humpback dolphin Sousa plumbea in the wild despite chronic osteologic pathologies

Skeletal examination of a female adult Indian Ocean humpback dolphin Sousa plumbea from South Africa suggested a chronic disease process. It manifested as erosions and pitting of the atlanto-occipital articulation as well as circumferential hyperostosis and ankylosis of some of the caudal vertebrae, findings rarely recorded together in the same animal. The character of the erosive process and vertebral fusion appeared chronic, and further findings of underdevelopment of the fluke, sternum and left humerus with remodeling of the periarticular region of the left scapula may support initiation of the process early in life. Because such chronic pathology would have affected the individual’s locomotion and foraging abilities, we also postulate how this individual survived until its demise in a human-derived environmental hazard. Ecological and socio-behavioral aspects observed in S. plumbea, including habitat preference for inshore and shallow waters, small social group aggregations and feeding cooperation, may have contributed to its ability to survive.

An osteological study of fusion of cervical vertebrae

An osteological study of fusion of cervical vertebrae

An osteological study of fusion of cervical vertebrae

Introduction: Fusion of vertebral column is a common finding in both radiological studies and in anatomical studies. The present study was focussed only on the fusion of the cervical vertebrae. The present study is to study the morphology of fused cervical vertebrae and its clinical aspect. Materials and Methods: The present study was conducted on 200 dry cervical vertebrae of both the sexes in Department of Anatomy, Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh. The bones were carefully studied and digitally photographed. Results: In this study the incidence of fused cervical vertebrae was 0.5% (01 out of 200). Out of seven cervical vertebrae the fusion was only seen in C2-C3 Vertebrae. Conclusions: The overall incidence of the fused cervical vertebrae in this study was only 0.5%. The fusion of cervical vertebrae is commonly associated with Klippel-Feil Syndrome, Crouzon’s syndrome and Chorda Dorsalis. The fusion of the cervical vertebrae causes restricted and painful neck movements and can cause sudden death also. The knowledge of such fusion is important for anatomists, neurosurgeons, radiologists, orthopaedic surgeons, neurologists, physiotherapists and even orthodontists. The knowledge of the fusion of cervical vertebrae is important for anaesthetist while doing endotracheal intubation where extension of the neck is done. Keywords: Cervical vertebrae