Transverse Processes Of Lumbar Vertebrae Research Articles

Effectiveness and safety of massage in the treatment of the congenital muscular torticollis: A systematic review and meta-analysis protocol.

Background:Massage has been widely used in the treatment of muscular torticollis in children, but there is no objective and systematic evaluation of the efficacy of various literature, and the efficacy of massage in the treatment of congenital muscular torticollis (CMT) is not clear. The purpose of this study is to evaluate the clinical efficacy and safety of massage in the treatment of muscular torticollis in children.Methods:Relevant randomized controlled trials (RCTs) will be searched from the databases of PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database from their inception to May 2020. Two reviewers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The RevMan V.5.3 will be used for meta-analysis.Results:This study will provide an assessment of the current state of Chinese massage therapy for the congenital muscular torticollis, aiming to show the efficacy and safety of massage treatment.Conclusion:This study will provide evidence to judge whether massage is an effective intervention for the third lumbar vertebrae transverse process syndrome.INPLASY registration number:INPLASY202070086.

Acupotomy for third lumbar vertebrae transverse process syndrome

Background:Acupotomy has been widely used clinically to relieve low back pain. However, the efficacy of acupotomy for the third lumbar vertebrae transverse process syndrome is still uncertain. The aim of this study is to determine the effectiveness and safety of acupotomy therapy for the third lumbar vertebrae transverse process syndrome.Methods:Relevant randomized controlled trials will be searched from the databases of PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database from their inception to May 2020. Two reviewers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The RevMan V.5.3 will be used for meta-analysis.Results:This study will provide an assessment of the current state of acupotomy for the third lumbar vertebrae transverse process syndrome, aiming to show the efficacy and safety of acupotomy treatment.Conclusion:This study will provide evidence to judge whether acupotomy is an effective intervention for the third lumbar vertebrae transverse process syndrome.PROSPERO registration number:CRD42019134945.

GUT MICROBIOTA AND AUTISM

The purpose of this study was to comparatively investigate the posterolateral fusion rate in ovariectomized (OVX) rats using two new bone graft materials: strontium (Sr) substituted hydroxyapatite (HA) nanocrystals and alendronate (AL) functionalized HA nanocrystals. SrHA was synthesized in presence of different Sr concentrations (SrHA5; SrHA10) and HA-AL nanocrystals at increasing bisphosphonate (BP) content (HA-AL7; HA-AL28).A posterolateral spinal fusion model in twenty-five Sham operated and in twenty-five OVX female rats was used and materials were bilaterally implanted between transverse processes of lumbar vertebrae. Sham and OVX animals were divided in five groups depending on the material: HA, SrHA5, SrHA10, HA-AL7 and HA-AL28. The assessment of bone fusion was carried out by μCT, histology and histomorphometry.Some gaps between the transverse processes were observed by μCT in OVXHA group, while they were not present in all the other groups. These results were consistent with the histomorphometrical analyses showing that in OVX animals SrHA and HA-AL materials displayed significantly higher BV/TV and Tb.Th and significantly lower Tb.N and Tb.Sp in comparison with HA alone.Results of this study suggest that in spinal fusion the incorporation of bioactive ions or drugs as Sr and AL improves the biological performance of HA representing a promising strategy especially in osteoporosis patients with high risks of spinal fusion failure. Results also suggest the existence of a Sr and AL dose response effect and that HA containing the highest AL dose could be the candidate biomaterial for spinal fusion in osteoporotic subjects.

Study of the morphometric variations of the neural arch in the lumbar vertebrae in adult human skeleton of North Indian population

Measurement of human vertebral geometry is important for accurate surgical procedures. The aim of this study is to measure the neural ach shape from L1 to L5. All Lumbar dry vertebrae (N = 150) of 30 individuals is measured and analyzed by gender. A Digital Vernier Caliper is used to measure the dimensions of the spinous (SP) and transverse (TP) processes, vertebral canal (VC), laminae, and isthmus. Most of the parameters are greater in males. Isthmus length decreases from L1 to L5 vertebrae in males with left side length greater than that of right in the lumbar region. In lumbar vertebrae transverse process length is increasing from L1 (17.83 mm) to L3 (22.58 mm) then decreasing till L5 (18.70 mm) with right side length more than the left side at L1 to L5. Vertebral Superior Canal Width (VSCW) is increasing more than Vertebral Superior Canal length (VSCL) in lumbar vertebrae. The difference of width and length is increasing from L1 (5.65 mm) to L5 (9.28 mm). The shape of vertebral canal is oval in lumbar vertebrae. In conclusion, the neural arch is systematically asymmetrical and dynamic in shape along the lumbar spine.

Antiresorptive properties of strontium substituted and alendronate functionalized hydroxyapatite nanocrystals in an ovariectomized rat spinal arthrodesis model

PurposeThe purpose of this study was to comparatively investigate the posterolateral fusion rate in ovariectomized (OVX) rats using two new bone graft materials: strontium (Sr) substituted hydroxyapatite (HA) nanocrystals and alendronate (AL) functionalized HA nanocrystals. SrHA was synthesized in presence of different Sr concentrations (SrHA5; SrHA10) and HA-AL nanocrystals at increasing bisphosphonate (BP) content (HA-AL7; HA-AL28). MethodsA posterolateral spinal fusion model in twenty-five Sham operated and in twenty-five OVX female rats was used and materials were bilaterally implanted between transverse processes of lumbar vertebrae. Sham and OVX animals were divided in five groups depending on the material: HA, SrHA5, SrHA10, HA-AL7 and HA-AL28. The assessment of bone fusion was carried out by μCT, histology and histomorphometry. ResultsSome gaps between the transverse processes were observed by μCT in OVXHA group, while they were not present in all the other groups. These results were consistent with the histomorphometrical analyses showing that in OVX animals SrHA and HA-AL materials displayed significantly higher BV/TV and Tb.Th and significantly lower Tb.N and Tb.Sp in comparison with HA alone. ConclusionsResults of this study suggest that in spinal fusion the incorporation of bioactive ions or drugs as Sr and AL improves the biological performance of HA representing a promising strategy especially in osteoporosis patients with high risks of spinal fusion failure. Results also suggest the existence of a Sr and AL dose response effect and that HA containing the highest AL dose could be the candidate biomaterial for spinal fusion in osteoporotic subjects.

Idiopathic and normal lateral lumbar curves: muscle effects interpreted by 12th rib length asymmetry with pathomechanic implications for lumbar idiopathic scoliosis.

BackgroundThe historical view of scoliosis as a primary rotation deformity led to debate about the pathomechanic role of paravertebral muscles; particularly multifidus, thought by some to be scoliogenic, counteracting, uncertain, or unimportant. Here, we address lateral lumbar curves (LLC) and suggest a pathomechanic role for quadrates lumborum, (QL) in the light of a new finding, namely of 12th rib bilateral length asymmetry associated with idiopathic and small non-scoliosis LLC.MethodsGroup 1: The postero-anterior spinal radiographs of 14 children (girls 9, boys 5) aged 9–18, median age 13 years, with right lumbar idiopathic scoliosis (IS) and right LLC less that 10°, were studied. The mean Cobb angle was 12° (range 5–22°). Group 2: In 28 children (girls 17, boys 11) with straight spines, postero-anterior spinal radiographs were evaluated similarly to the children with the LLC, aged 8–17, median age 13 years. The ratio of the right/left 12th rib lengths and it’s reliability was calculated. The difference of the ratio between the two groups was tested; and the correlation between the ratio and the Cobb angle estimated. Statistical analysis was done using the SPSS package.ResultsThe ratio’s reliability study showed intra-observer +/−0,036 and the inter-observer error +/−0,042 respectively in terms of 95 % confidence limit of the error of measurements. The 12th rib was longer on the side of the curve convexity in 12 children with LLC and equal in two patients with lumbar scoliosis. The 12th rib ratios of the children with lumbar curve were statistically significantly greater than in those with straight spines. The correlation of the 12th rib ratio with Cobb angle was statistically significant. The 12th thoracic vertebrae show no axial rotation (or minimal) in the LLC and no rotation in the straight spine group.ConclusionsIt is not possible, at present, to determine whether the 12th convex rib lengthening is congenitally lengthened, induced mechanically, or both. Several small muscles are attached to the 12th ribs. We focus attention here on the largest of these muscles namely, QL. It has attachments to the pelvis, 12th ribs and transverse processes of lumbar vertebrae as origins and as insertions. Given increased muscle activity on the lumbar curve convexity and similar to the interpretations of earlier workers outlined above, we suggest two hypotheses, relatively increased activity of the right QL muscle causes the LLCs (first hypothesis); or counteracts the lumbar curvature as part of the body’s attempt to compensate for the curvature (second hypothesis). These hypotheses may be tested by electrical stimulation studies of QL muscles in subjects with lumbar IS by revealing respectively curve worsening or correction. We suggest that one mechanism leading to relatively increased length of the right 12 ribs is mechanotransduction in accordance with Wolff’s and Pauwels Laws.

Effects of transcutaneous electrical nerve stimulation on rats with the third lumbar vertebrae transverse process syndrome.

To investigate the analgesic and anti-inflammatory effects of transcutaneous electrical nerve stimulation (TENS) at local or distant acupuncture points in a rat model of the third lumbar vertebrae transverse process syndrome. Forty Sprague-Dawley rats were randomly divided into control, model, model plus local acupuncture point stimulation at BL23 (model+LAS) and model plus distant acupuncture point stimulation at ST36 (model+DAS) groups. All rats except controls underwent surgical third lumbar vertebrae transverse process syndrome modelling on day 2. Thereafter, rats in the model+LAS and model+DAS groups were treated daily with TENS for a total of six treatments (2/100 Hz, 30 min/day) from day 16 to day 29. Thermal pain thresholds were measured once a week during treatment and were continued until day 57, when local muscle tissue was sampled for RT-PCR and histopathological examination after haematoxylin and eosin staining. mRNA expression of interleukin-1 β (IL-1β), tumour necrosis factor-α (TNF-α) and inducible nitric oxide synthase (iNOS) was determined. Thermal pain thresholds of all model rats decreased relative to the control group. Both LAS and DAS significantly increased the thermal pain threshold at all but one point during the treatment period. Histopathological assessment revealed that the local muscle tissues around the third lumbar vertebrae transverse process recovered to some degree in both the model+LAS and model+DAS groups; however, LAS appeared to have a greater effect. mRNA expression of IL-1β, TNF-α and iNOS in the local muscle tissues was increased after modelling and attenuated in both model+LAS and model+DAS groups. The beneficial effect was greater after LAS than after DAS. TENS at both local (BL23) and distant (ST36) acupuncture points had a pain-relieving effect in rats with the third lumbar vertebrae transverse process syndrome, and LAS appeared to have greater anti-inflammatory and analgesic effects than DAS. 09073.

Morphology of Lateral Femoral Cutaneous Nerve (LFCN) of the thigh and its clinical significance

Background: The incidence of Meralgia Paresthetica (MP) is increasing and is related to various surgical procedures. The obvious reason is that the description of Lateral femoral cutaneous nerve of thigh is inadequate. Aims and objectives: This study aims to record variations in origin of lateral femoral cutaneous nerve, to compile the findings and to analyze the clinical aspect related to variations so recorded and to compare the study to previous studies. Methodology: The study was performed on 30 formalin embalmed cadavers in the department of anatomy, Government Medical College, Patiala. The muscles of the posterior abdominal wall were exposed. The fibers of psoas major muscle were dissected from the transverse processes of lumbar vertebrae and the nerves of lumbar plexus were exposed. Results: In all the specimens, it was found that the lateral femoral cutaneous nerve was passing through the substance of psoas major muscle and emerged from its lateral border. Lateral femoral cutaneous nerve showed its origin from L2 and L3 only in 46.6% of plexuses. In the rest of the cases, it showed variations in the morphological root value. It was found to be absent in 10 plexuses. It arose directly from femoral nerve in 5 plexuses. Conclusion: Meralgia Paraesthetica (MP) is very commonly overlooked or confused with femoral or sciatic pain or other nerve root impingements. The knowledge of anatomical variations of the lateral femoral cutaneous nerve of thigh is essential to the surgeons to avoid iatrogenic injury to the nerve and to the clinicians while treating the cases of meralgia paresthetica.

Effect of acupotomy on nitric oxide synthase and beta-endorphin in third lumbar vertebrae transverse process syndrome model rats

ObjectiveTo explore the long-term effects and pain relief mechanism of acupotomy by observing changes in nitric oxide synthase (NOS) and beta-endorphin (β-EP) in the hypothalamus, spinal cord, and peripheral blood of rats with third lumbar vertebrae (L3) transverse process syndrome. MethodsTwenty-eight SD rats were randomly assigned to normal, model, electroacupuncture (EA), and acupotomy group. The last three groups were put through an operation to emulate L3 transverse process syndrome. Fourteen days after the simulation operation, EA and acupotomy treatments were applied to the respective groups. Fifty-six days after the simulation operation, biochemistry tests and enzyme-linked immunosorbent assay were used to measure NOS and β-EP in the hypothalamus, spinal cord, and peripheral blood. ResultsRats with the simulation operation showed significantly higher levels of NOS and β-EP in the hypothalamus, spinal cord, and peripheral blood than those in the normal group. The EA and acupotomy groups had significantly lower levels of NOS and β-EP than those in the model group. There was no statistical difference between the EA and acupotomy groups. ConclusionEA and acupotomy treatments significantly lowered NOS and β-EP levels in the hypothalamus, spinal cord, and peripheral blood and alleviated L3 transverse process syndrome.

Spinal fusion with demineralized calf fetal growth plate as novel biomaterial in rat model: a preliminary study

BackgroundSpinal fusions are being performed for various pathologies of the spine such as degenerative diseases, deformities, tumors and fractures. Recently, other bone substitutes such as demineralized bone matrix (DBM) have been developed for spinal fusion. Therefore, this study was conducted to evaluate the intertransverse posterolateral fusion with the Bovine fetal growth plate (DCFGP) and compare it with commercial DBM in rat model.MethodsA total of 16 mature male rats (aged 4 months and weighing 200-300 g) were randomly divided in two groups. After a skin incision on posterolateral site, two separate fascial incisions were made 3 mm from the midline. A muscle-splitting approach was used to expose the transverse processes of L4 and L5. Group I (n = 8) underwent with implanted Bovine fetal growth plate among decorticated transverse processes. In group II (n = 8) commercial DBM was placed in the same manner. Fusion was evaluated by manual palpation, radiographical, gross and histopathological analysis.ResultsThe manual palpation, radiological, gross and histopathological findings indicate high potential of the DCFGP in spinal fusion. At the 42nd postoperative day, new bone formation as evidenced by a bridge between L4 and L5 was visualized in all rats implanted with DCFGP and commercial DBM. The newly formed bone tissue was observed in all implanted areas on the 42nd day after operation in the two groups.ConclusionsThe spinal fusion of the animals of both groups demonstrated more advanced osteogenic potential and resulted in proper fusion of the transverse process of lumbar vertebra.

Effects of acupuncture knife on inflammatory factors and pain in third lumbar vertebrae transverse process syndrome model rats.

The aim of this paper was to explore the long-term effects and pain relief mechanism of acupuncture knife on third lumbar vertebrae (L3) transverse process syndrome. Forty SD rats were randomized into control, model, electroacupuncture (EA), and acupuncture knife (AK) group. Except control rats, other rats were subjected to an operation to emulate L3 transverse process syndrome. Fourteen days after the operation, EA and AK rats were given electroacupuncture and acupuncture knife treatments, respectively. Fifty-six days after the operation, enzyme-linked immunosorbent assay was used to measure substance P (SP), 5-hydroxytryptamine (5-HT), interleukin-1β (IL-1β), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and transforming growth factor-β (TGF-β) in peripheral blood. The tail flick test was used to observe pain threshold. We found that rats with the simulation operation had significantly higher levels of SP, 5-HT, IL-1, IL-10, TNF-α, and TGF-β, while the AK rats had lower levels. In addition, the pain threshold of AK rats was similar to that of control rats. AK pretreatment could alleviate pain through modulating inflammatory response.

Lumbar roots radiculopathy caused by traumatic fracture of transverse process of lumbar vertebra: case report

Lumbar roots radiculopathy caused by traumatic fracture of transverse process of lumbar vertebra: case report

Effects of Needle-knife Therapy on iNOS Activity and NO Content in Skeletal Muscles in the L 3 Transverse Process Syndrome Model Rat

To study on relationship of inducible nitric oxide synthase (iNOS) activity and nitric oxide (NO) content in the injured local soft tissue with injured degrees of the soft tissue in the third lumbar vertebrae (L3) transverse process syndrome model rat and to observe the effect of needle-knife therapy. One hundred and sixty male SD rats were randomly divided into normal group, model group, aminoguanidine (AG) group, needle-knife group, 40 rats in each group. The L3 transverse process syndrome rat model was established, and after treatment of needle-knife and AG iNOS activities and NO contents and histomorpholocal changes in the soft tissues around L3 transverse process on 1, 3, 7 and 14 days were observed in the groups. Compared with the normal group, iNOS activity and NO content in the model group were significantly increased (P < 0.01); Compared with the model group, iNOS activities and NO contents were significantly decreased in both the needle-knife group and the AG group (both P < 0.01); And both iNOS activities and NO contents were identical with both local inflammation response and injured degrees of the injured tissue in the groups. Needle-knife therapy can significantly inhibit generation of NO, alleviate inflammatory response and injured degree of the injured soft tissue, improve microcirculation, prevent formation of pathological scar tissue, and promote repair of the chronic soft tissue injury.

Repair of Transverse Process Fractures of Multiple Lumbar Vertebrae in an Adult Dairy Cow

To report lumbar vertebrae transverse process fracture repair using a narrow 3.5 mm limited contact dynamic compression plate (LC-DCP) in an adult dairy cow. Case report. A 3-year-old Holstein cow. Under general anesthesia, fractured left transverse processes of lumbar vertebrae 2-4 were repaired using internal fixation. A narrow 3.5 mm LC-DCP was contoured and secured to the spinous process and the transverse process of each fractured vertebra. Fractured transverse processes of the lumbar vertebrae were successfully repaired and the cow discharged 10 days after surgery. At 10 months after surgery, the cow was declared reserved champion at a regional show. A paramedian approach and muscle splitting can be used to repair multiple lumbar transverse process fractures using internal fixation with an excellent cosmetic outcome.

Effect of exogenous recombined human bone morphogenetic protein-2 on cell proliferation in lumbar spinal fusion in a rabbit model

Objective To explore the effects of exogenous recombined human bone morphogenetic protein-2(rhBMP-2)on cell proliferation in posterolateral lumbar spinal fusion in a rabbit model. Methods Forty-five rabbits that had received posterior graft fusion of transverse process of lumbar vertebra were randomly divided into 3 groups: rhBMP-2/allograft composite group, autologous iliac crest bone graft group, and allograft group. The proliferations of marrow stromal cells (MSCs), osteoblasts and vascular endothelial cells were detected at different times by flow cytometry. Results The numbers of MSCs in the rhBMP-2/allograft composite group at the 2nd, 7th, 35th days after graft transplantation were significantly greater than in the autologous iliac crest bone graft group and allograft group (P 0.05) except at the 2nd day (P=0.028). The quantity of osteoblasts in composite group was significantly larger than in the allograft group at all time points (P<0.05) . The quantities of vascular endothelial cells in the composite group at the 2nd, 7th, 28th days after operation were significantly larger than in the autologous iliac crest bonegraft group (P<0.05). Conclusion The exogenous rhBMP-2 may have a promoting effect on proliferation of MSCs, osteoblasts, vascular endothelial cells at different times during the spinal graft fusion. Key words: Bone morphogcnetic protein; Spinal fusion; Bone transplantation; Cell proliferation

Augmentation of intertransverse process lumbar fusion

Spinal fusion surgery for alleviation of intractable lower back pain in humans is currently a primary therapeutic technique, with failure rates averaging between 5 to 35%. Implanted and external source-based electrical stimulation devices have been investigated in an attempt to increase osteogenesis at the fusion site in an attempt to reduce spinal fusion failure rates. The purpose of our study was to evaluate the efficacy of two co-processor systems and an additional system with an SIS generation field at 15.8 mA (rms) using biomechanical, dual-energy X-ray absorptiometry (DXA), and histomorphometric analyses, in rabbits following dorsolateral (= posteriolateral [in humans]) spinal fusion. Fifty-six male New Zealand White underwent bilateral lumbar spinal fusion by performing decortication of the transverse processes of lumbar vertebrae four and five with placement of autogenic cancellous bone graft harvested from the ilial wings. Four study groups were designated based on the type of IES device used for stimulation or as a control. Eight weeks after surgery all subjects were sacrificed and the quality and strength of the fusion masses were compared using radiographic, biomechanical, histomorphometry, and qualitative histological evaluation. While some variation existed within and between groups, Group 2 showed a significant improvement in all parameters measured as compared to the control group (P < 0.05). The use of adjunct non-invasive surface IES for improving bony fusion rates for patients undergoing lumbar spinal fusion is supported by this study.

Lumbar transverse process fractures in professional football players.

In the general population, fractures of the transverse processes of lumbar vertebrae occur in cases of high-energy blunt trauma, often in motor vehicle accidents. Football players may incur the same fractures, but the circumstances and outcomes are different in this specific subgroup. A review of 29 cases among National Football League players reveals that associated visceral injuries are rare, and the time lost from sports is only an average of 3.5 weeks.