Lumbosacral Vertebral Column Research Articles

Preliminary evaluation of a novel method for computed tomography quantification of lumbosacral articular process displacement in dogs with and without degenerative lumbosacral stenosis.

This study aimed to describe the diagnostic discrimination and reliability of a novel technique for quantifying lumbosacral articular process displacement (LSAPD) on dorsal plane computed tomography (DPCT) imaging in dogs with and without degenerative lumbosacral stenosis (DLSS). DPCT surveys of the lumbosacral vertebral column were performed with dogs positioned in extension and flexion. LSAPD is defined as the distance between the cranial aspects of the L7 and S1 articular processes. The LSAPD ratio is identified by dividing the LSAPD by the length of the L7 articular process. Intraclass correlation coefficients (ICCs) for intra- and inter-observer reliability were calculated, and logistic regressions were used to test for the association of LSAPD and LSAPD ratio with odds of DLSS. Significance was set at 0.05. Receiver operator characteristic (ROC) curves were calculated to determine diagnostic discrimination and optimal cutoff for LSAPD and LSAPD ratio in the diagnosis of DLSS. Intra- and inter-observer reliabilities were excellent for most measurements. In the current cohort, excluding covariates, the area under the curve (AUC) (95%CI) for LSAPD and LSAPD ratio measured in a flexed position were both 0.89 (0.82-0.96), suggesting potentially excellent discrimination for using this measurement as a marker for diagnosing DLSS, pending further studies. The cutoffs for flexed LSAPD and LSAPD ratio that maximizes Youden's index were ≥ 1.2 mm and ≥ 9%, respectively. When age and weight were subsequently included as covariates in a multivariable analysis, a significant relationship between LSAPD or LSAPD ratio and odds of diagnosis of DLSS was not demonstrated, suggesting the need for a larger sample size. The results of this study suggest that measurements of LSAPD and LSAPD ratio on DPCT are feasible and reliable, although their diagnostic discrimination in DLSS should be evaluated further in future prospective studies.

Lumbar spinal arachnoid diverticulum in a cat

AbstractA 5‐year‐old, domestic, shorthair, male, neutered cat was referred to the Companion Animal Clinic with a history of paraparesis and urinary incontinence, alongside recurrent urinary tract infections. Magnetic resonance imaging of the lumbar vertebral column revealed a space‐occupying spinal cyst‐like lesion located at the level of fifth and sixth lumbar vertebrae. Surgical treatment consisted of dorsal laminectomy and durectomy, resulting in decompression. Histopathology findings were indicative of spinal arachnoid diverticulum. Postoperatively, the cat exhibited gradual hindlimb and tail motor improvement, and recovery of voluntary urination. Complete resolution of the neurological signs was achieved at 3 months after surgery. No signs of recurrence were noted till the time of writing this report, 14 months postoperatively. To the authors’ knowledge, this is the first case report of a spinal arachnoid diverticulum in the lumbosacral vertebral column in a cat.

Blood Flow Restricted Training as the Last-Opportunity, Non-Invasive Treatment for a Patient Suffering from Peripheral Arterial Disease Without Possibility for Implementing Conventional Walking Exercise Rehabilitation a Case Report

Introduction and Objectives: We report a non-invasive and innovative treatment method with blood flow restricted training (BFR) in a 62-year-old man with short-distance claudication of the right calf (Rutherford 3), and post-thrombotic deep vein syndrome of the same limb. This is the first described case of BFR training used in the rehabilitation of a patient with lower limb ischaemia.Material and Methods: The patient, undertaking frequent physical activity, a previous cigarette smoker, with a history of deep vein thrombosis, was diagnosed with occlusion of the popliteal and anterior tibial arteries causing intermittent, short-distance claudication. An invasive approach was not possible, as the patient refused any vascular surgery interventions, open or endovascular. Due to recently diagnosed hip joint degeneration, accompanied by degeneration and dyscopathy of the lumbosacral vertebral column, regular supervised walking training could not be implemented. Experimental blood flow restricted low-intensity training, with the use of a cross-trainer tool accompanied by cooling, was introduced. The 21-minute training, 3 times per week for 3 months, was performed in a seated position with a special low-pressure cuff placed on the arms and legs.Results: The patients limb symptoms were promptly reduced and the vascular parameters significantly improved, allowing surgical treatment of the right hip joint. The patient continued the non-invasive treatment for peripheral arterial disease in the form of walking training.Conclusions: Blood flow restriction training may be individually considered for patients with peripheral arterial disease having limited possibilities of classic walking training and revascularization, but this should be done with great caution and after detailed consultation with a vascular medicine specialist.

Use of 3D Printing Technology to Create a Canine Simulator for Cerebrospinal Fluid Sampling at the Lumbar Subarachnoid Space.

Cerebrospinal fluid (CSF) sampling at the lumbar subarachnoid space (LSS) is technically challenging to learn. Currently, training relies on cadaver availability or performance in a clinical scenario. This study aims to develop and validate a low-cost, high-fidelity simulator to train in this technique. Using three-dimensional printing technology, a model of a healthy adult dog's lumbosacral vertebral column was produced. The model was augmented with synthetic materials and a fluidic system to replicate all procedural steps and permit successful CSF collection. The simulator was validated by four experts, who rated it highly across multiple criteria. Final-year veterinary students were recruited to take part in practical sessions using either the simulator (n = 16) or a cadaver (n = 16). Performance was recorded for each student, and feedback was obtained using an anonymous online survey. Student performance was similar between groups (p = .2), with 87.5% and 68.75% of students in the simulator and cadaver group, respectively, successfully placing the needle into the LSS. All successful students in the simulator group were able to obtain a CSF sample, versus none in the cadaver group. No difference in the number of attempts was detected between groups (p > .99), with most students taking more than three attempts. User experience was similar between groups, with 93.8% of students in each group rating the session as a positive learning experience. In summary, we demonstrate the validity of a novel, low-cost, and anatomically precise simulator that can be used for teaching CSF sampling at the LSS.

Congenital malformations of the lumbosacral vertebral column are common in neurologically normal French Bulldogs, English Bulldogs, and Pugs, with breed-specific differences.

Congenital vertebral malformations are common findings on diagnostic imaging of the vertebral column in "screw-tailed" brachycephalic dogs. The aims of this study were to evaluate the prevalence and anatomical characteristics of lumbosacral congenital vertebral malformations in French Bulldogs, English Bulldogs, and Pugs presenting for problems unrelated to spinal disease, as well as possible associations with the degree of tail malformation, lumbosacral intervertebral disc herniation, or spondylosis deformans. In this retrospective cross-sectional study, CT scans of vertebrae L6 to S3 and of the coccygeal vertebrae were reviewed for type of congenital vertebral malformations (hemivertebrae, block vertebrae, lumbosacral transitional vertebrae, and spina bifida), lumbosacral intervertebral disc herniation, lumbosacral spondylosis deformans, and degree of tail malformation. In 76 (51.0%) of the 149 included dogs (53 French Bulldogs, 37 English Bulldogs, and 59 Pugs) at least one type of congenital vertebral malformations was found, with lumbosacral transitional vertebrae being the most common (34.2%). There was a significantly higher prevalence of lumbosacral transitional vertebrae (54.2%) and lower prevalence of hemivertebrae (1.7%) in Pugs compared to English (13.5% and 24.3%, respectively) and French Bulldogs (26.4% and 32.0%, respectively). Tail malformation was significantly more severe in dogs with evidence of hemivertebrae. Congenital vertebral malformations are a common finding in the lumbosacral vertebral column of French Bulldogs, English Bulldogs, and Pugs. These anatomical variances need to be considered when interpreting diagnostic studies and when planning for neurosurgical and neurodiagnostic procedures. Furthermore, this study suggests a possible association between the degree of tail malformation and lumbosacral hemivertebrae.

Cauda equina syndrome in dogs - a review

A lesion of sacrococcygeal spinal nerve roots forming a structure that resembles a horse's tail results in the development of clinical entity identified as the cauda equina syndrome (CES). The disease can evolve slowly and symptomatology can be incomplete, but the fully developed CES is characterized by pain and altered sensation in the pelvic extremities, tail, perianogenital region, paresis or plegia of hind limbs, incontinence and impotence. Major causes of CES in dogs are degenerative changes of the lumbosacral vertebral column, haematoma, inflammation, neoplasm or trauma. The diagnosis is based on history, clinical presentation, neurological symptomatology, spinal röntgenography, computed tomography, and magnetic resonance imaging. In animals experiencing initial episodes of CES, conservative therapy can be attempted. But the only rational treatment of patients with severe neurological deficit is surgical decompression of the neural structures. The outcome depends on the underlying aetiology and the degree of sensory, motor and autonomic dysfunction. Canine and porcine experimental models mimicking the CES showed the involvement of intrinsic spinal cord structures. This points out the need for an early diagnosis followed by aggressive management before irreversible neuronal lesions develop. The search strategy involved the PubMed, Medline, Embase and ISI Web of Science from January 2000 to August 2017 using the terms 'cauda equina syndrome' and 'lumbosacral stenosis' in the English language literature; also references from selected papers were scanned and relevant articles included.

Development of 3-D finite element model of lumbosacral vertebral column

Development of 3-D finite element model of lumbosacral vertebral column

The structure and development of avian lumbosacral specializations of the vertebral canal and the spinal cord with special reference to a possible function as a sense organ of equilibrium

The avian lumbosacral vertebral column and spinal cord show a number of specializations which have recently been interpreted as a sense organ of equilibrium. This sense organ is thought to support balanced walking on the ground. Although most of the peculiar structures have been described previously, there was a need to reevaluate the specializations with regard to the possible function as a sense organ. Specializations were studied in detail in the adult pigeon. The development of the system was studied both in the pigeon (semiprecocial at hatching) and in the chicken (precocial). Specializations in the vertebral canal consist of a considerable enlargement, which is not due to an increase in the size of the spinal nervous tissue, but to a large glycogen body embedded in a dorsal rhomboid sinus. The dorsal wall of the vertebral canal shows segmented bilateral dorsal grooves, which are covered by the meninges towards the lumen of the vertebral canal leaving openings in the midline and laterally. This results in a system of lumbosacral canals which look and may function similar to the semicircular canals in the inner ear. Laterally these canals open above ventrolateral protrusions or accessory lobes of the spinal cord which contain neurons. There are large subarachnoidal cerebrospinal fluid spaces, lateral and ventral to the accessory lobes. Movement of this fluid is thought to stimulate the lobes mechanically. As to the development of avian lumbosacral specializations, main attention was given to the organization of the lobes and the adjacent fluid spaces including the dorsal canals. In the pigeon the system is far from being adult-like at hatching but maturates rapidly after hatching. In the chicken the system looks already adult-like at hatching. The implications derived from the structural findings are discussed with regard to a possible function of the lumbosacral specializations as a sense organ of equilibrium. The adult-like organization in the newly hatched chickens, which walk around immediately after hatching, supports the assumed function as a sense organ involved in the control of locomotion on the ground.

Atypical parasitic ischiopagus conjoined twins

Occurrence of asymmetrical or parasitic conjoined twins (CT) is rare, and currently they are classified analogically to the common unions of symmetrical CT. The authors report on an infant with a parasitic third limb attached to the left lateral aspect of the autosite trunk, in whom male gonadal tissue was found histologically. Parasite parts included complete left lower limb, hemipelvis, lumbosacral vertebral column, spinal cord, and one kidney with ureter and adrenal gland. Autosite anomalies comprised a small left diaphragmatic defect, omphalocele, exstrophy of cloaca, and lumbar meningomyelocele. The authors considered this case to be a rare atypical parasitic ischiopagus CT. The differential diagnosis of the type of twining and other entities with caudal duplications is analyzed briefly. J Pediatr Surg 38:E3. Copyright 2003, Elsevier Science (USA). All rights reserved.

Association between postoperative outcome and results of magnetic resonance imaging and computed tomography in working dogs with degenerative lumbosacral stenosis.

To determine whether results of magnetic resonance imaging (MRI) and computed tomography (CT) are associated with postoperative outcome in working dogs with degenerative lumbosacral stenosis. Prospective cohort study. 12 dogs treated surgically for degenerative lumbosacral stenosis. The lumbosacral vertebral column was examined before surgery by use of MRI and CT and after surgery by use of CT. Outcome, based on performance in standardized training exercises, was assessed 6 months after decompressive surgery. Associations between imaging results and postoperative outcome were determined by use of a Fisher exact test and logistic regression. None of the dogs were able to perform their duties before surgery. By 6 months after surgery, 8 of 12 dogs had been returned to full active duty. Nerve tissue compression was effectively localized by use of CT and MRI. Significant associations between results of imaging studies and postoperative outcome were not identified. Surgical intervention is justified in high-performance working dogs with degenerative lumbosacral stenosis. However, results of imaging studies may be less important than clinical or surgical factors for predicting outcome in affected dogs.

Magnetic coil stimulation of the human lumbosacral vertebral column: site of stimulation and clinical application

We describe the technique of magnetic coil (MC) stimulation of the lumbosacral roots and the possible site of stimulation in 22 control subjects, and the clinical usefulness of MC stimulation in 5 patients with low back pain. We observed 2 components in the compound muscle action potential of the soleus muscle following MC stimulation over the lumbosacral region. The second component had the physiological properties of the H reflex. The conduction time from the anterior horn cells of the lumbosacral spinal cord to the site of nerve root stimulation over the lumbosacral vertebral column was indirectly calculated as between 3.9 and 4.1 msec. Assuming a conduction velocity of 50 m/sec this would represent a distance of approximately 20 cm from the spinal motor neurons. Based on our control and patient data we conclude that the MC stimulation may be an useful technique for the diagnosis of lumbosacral radiculoplexopathy.