Sacral Part Research Articles

Novel muscular anomaly along the iliac crest: Innervation from the superior cluneal nerves and topographical relationship to the thoracolumbar fascia.

Aberrant muscle bundles of approximately 10cm in length, running subcutaneously from the posterior surface of sacrum to the iliac crest, were found on both sides of three males among 93 cadavers of anatomical courses for medical students. Since no precedent of this anomaly has been described in the literature, we present its morphology and discuss the significance of this muscle. This muscle originated from the tendinous fibers of the superficial-most layer of the sacral part of thoracolumbar fascia, became muscularized near the posterior superior iliac spine, passed over the origins of the gluteus maximus and medius, and inserted on the iliac crest. Some bundles crossed the iliac crest to insert between sublayers of the posterior layer of the thoracolumbar fascia. The superior cluneal nerves passed above, below, or penetrated the muscle. Branches from the segmentally lowest one or the conjoined lowest two entered the aberrant muscles. Considering its location and multi-layered structure, the muscle is likely to be a muscularized bundle of the thoracolumbar fascia. The aberrant muscle is also similar to the serratus posterior inferior in its location at the lateral end of the thoracolumbar fascia and below the latissimus dorsi. Nevertheless its innervation from the posterior rami of the spinal nerves and partial fusion at its origin implies a close relationship to the iliocostalis. This aberrant muscle may also be of clinical interest since it is potentially involved in the entrapment of the superior cluneal nerves as it runs along the caudolateral edge of the thoracolumbar fascia.

Reconstruction of Oncological Defects in the Pelvic-perineal Region: Report on the Consensus Workshop at the 44th Annual Meeting of the DAM 2023 in Bern, CH

The surgical-oncological treatment of pelvic and perineal malignancies is associated with a high complication rate and morbidity for patients. Modern multimodal treatment modalities, such as neoadjuvant radio-chemotherapy for anal or rectal cancer, increase the long-term survival rate while reducing the risk of local recurrence. Simultaneously, the increasing surgical radicality and higher oncological safety with wide resection margins is inevitably associated with larger and, due to radiation, more complex tissue defects in the perineal and sacral parts of the pelvic floor. Therefore, the plastic-surgical reconstruction of complex pelvic-perineal defects following oncological resection remains challenging. The reconstructive armamentarium, and thus the treatment of such defects, is broad and ranges from local, regional and muscle-based flaps to microvascular and perforator-based procedures. While the use of flaps is associated with a significant, well-documented reduction in postoperative complications compared to primary closure, there is still a lack of reliable data directly comparing the postoperative results of different reconstructive approaches. Additionaly, the current data shows that the quality of life of these patients is rarely recorded in a standardised manner. In a consensus workshop at the 44th annual meeting of the German-speaking Association for Microsurgery on the topic of "Reconstruction of oncological defects in the pelvic-perineal area", the current literature was discussed and recommendations for the reconstruction of complex defects in this area were developed. The aim of this workshop was to identify knowledge gaps and establish an expert consensus to ensure and continuously improve the quality of reconstruction in this challenging area. In addition, the importance of the "patient-reported outcome measures" in pelvic reconstruction was highlighted, and the commitment to its widespread use in the era of value-based healthcare was affirmed.

Гистологические исследования мясной продукции по Sous vide на основе обзора известных подходов к формированию качества

Sous vide technology came to Russia in the early 2000s. Its quality standards require a multidimensional comprehensive study to develop theoretical and methodological foundations. The research featured the effect of various Sous vide modes on beef quality based on histological analysis and sensory assessment. The review of best practices in this sphere included publications registered in Scopus, Web of Science, and eLIBRARY.RU. Beef from sacral part underwent Sous vide processing at two modes, i.e., 57 and 64°C for 24 h and 80°C for 12 h. The samples obtained were subjected to histological analysis and sensory assessment. The histology showed that the cooking process at 100°C and the Sous vide modes at 57, 64, and 80°C increased the intercellular space and dissolved the connective tissue. Higher temperature modes led to more pronounced shrinking and deformation of muscle fibers. Under the Sous vide conditions, fibrous structures demonstrated the most severe destruction after 12 h at 80°C. As the destruction of muscle fibers increased, more nuclei entered intercellular space. Moreover, perimysium and sarcolemma demonstrated signs of granulation between muscle fiber bundles. The Sous vide samples received the best score for juiciness and tenderness. The research revealed a certain contradiction between the growing degree of fibrous destruction caused by thermal treatment and the improving consistency index for juiciness and tenderness. The authors consider it necessary to investigate the matter further and invite specialists to submit their ideas.

A Mass in the Buttock: The Sacral Chordoma, a Rare Primary Bone Tumor. About Two Cases and Review of the Literature

Chordomas are rare bone tumors. They represent 2 to 3% of primary bone tumors, affecting the sacral parts in the majority of cases. They are characterized by their insidious evolution. Imaging plays an important role in the diagnosis, particularly with standard radiography and CT scans, allowing an optimal evaluation of bone involvement, while MRI specifies the degree of invasion of soft tissue and neighboring structures. Ultrasound is also used to guide biopsy procedures, and interventional radiology, through the combination of angiography and radiological embolization, can limit the risk of bleeding during surgery. We report two observations illustrating the role of radiology at the diagnostic and therapeutic level in two patients diagnosed with chordoma.

Lumbosacral zone features in individuals with nonspecific chronic low back pain are unique compared to controls and correlate with pain and dysfunction.

To compare the lumbosacral nerve distances (LNDs) and sacroiliac joint (SIJ) morphology in individuals with nonspecific chronic low back pain (NSCLBP) and control and examine their correlations with pain and dysfunction in the former. The sample includes 200 adult patients (ranging from 20 to 50 years old) referred for computerized abdominal tomography (CT): 100 individuals with NSCLBP (50 males and 50 females) and 100 individuals without NSCLBP (50 males and 50 females). CT scans were assessed for LNDs, degenerative sacroiliac changes, and joint bridging. Those factors were correlated to the outcomes of three self-reported questionnaires about pain and function (Oswestry, Fear-Avoidance, and Numerical Pain Rating Scale) in the NSCLBP group. Individuals with NSCLBP tend to have reduced LNDs from the sacral part of the SIJ compared to controls (males: right Δ = 5.8 mm, left Δ = 6.03 mm; females: right Δ = 7.9 mm, left Δ = 7.73 mm, two-way ANOVA, p < 0.01), with moderate significant negative correlations with all three questionnaires (-0.38 < Pearson's r < - 0.57, p < 0.02, i.e., reduced LNDs with greater disability and pain). The NSCLBP group had more significant SIJ degeneration severity that moderately correlated with two questionnaires (0.39 < Pearson's r < 0.66, p < 0.04, i.e., greater SIJ degeneration with greater disability and pain). In males, the existence of SIJ bridging strongly correlated with all three questionnaires (0.38 < Pearson's r < 0.78, p < 0.03), and in females, only the Fear-Avoidance Questionnaire and Numerical Pain Scale (0.29 < Pearson's r < 0.41, p < 0.04). Compared to controls, individuals with NSCLBP have reduced LNDs and worse SIJ degenerative changes that correlate with function and pain. • Individuals with nonspecific low back pain tend to have reduced lumbosacral nerve distances than healthy controls. This may be due to entrapments or inflammation of the nerves or surrounding tissues. • Individuals with nonspecific low back pain tend to have more severe degeneration of their sacroiliac joint than healthy controls. • The above findings significantly correlated with the scores of three self-reported questionnaires about pain and function, implicating that they may be of clinical significance.

ADYGHE RIDING OF THE XIX – EARLY XXI CENTURIES IN MODERN HISTORIOGRAPHY

Background. For the last ten years small nations start to interest in their national culture. Many researches on adygs traditional upbringing and dzhigitovka appear. The object of research is adyg dzhigitovka described in scientific literature at the beginning of XXI century in Russian and adyg languages, which is based on XIX-beginning of XX century historical sources. The subject of researchis the elements of adygdzhigitovka found in published materials.&#x0D; Purpose. The aim of the research is to determine research degree of adyg dzhigitovka and to generate a list of today known elements of adyg dzhigitovka.&#x0D; Materials and methods. Works of modern historians, philologists, linguists and educators on dzhigitovka, which is an element of traditional adyg masculine upbringing, are the materials for researching. We use historical and systematic method for determining complete adyg dzhigitovka upbringing complex and we also use the comparative and typological method for systemizing elements of adyg dzhigitovka as a martial art.&#x0D; Results. For XIX–XXI centuries adyg dzhigitovka consists of four elements. The most known are those related to martial art. The less known are methodsfor boys physical training. Ideological and sacral parts of adyg masculine upbringing is known from Nartskii epos. And it is also known since adyg scientists Bgazhnokov B.Kh., Kuek M.G. and Kuek A.S., who are culture-bearers, partly desacralize it. Dzhigitovka as a martial art contains many variants of target shooting and a little acrobatic elements. Also there are two or three traditional battle tactics andsome horse tests including practical and sacral ones.&#x0D; Practical implications. The results of investigation can be used for reviving adyg dzhigitovka as a part of national athletic upbringing and for saving immaterialcultural heritage of the North Caucasus.

Qualitative characteristics of young horse meat of different breeds of horses in Yakutia

The purpose of the work was to study the biochemical composition and nutritional value of the meat of foals of Prilenskaya and Megezhekskaya breeds in comparison with the original Yakut breed. Based on special analyses, the indicators of nutritional value and biochemical composition of the meat of foals of the studied breeds have been studied. As a result of the conducted research, the expediency of using stationary pre-slaughter maintenance of foals of above-average fatness for 4 days in order to improve the quality indicators of horse meat has been objectively proved. In a comparative study of different cut of meat of 6-month-old foals of the three above-mentioned breeds, it has been found that the meat of horses of the indigenous type of Yakut breed and Prilenskaya breed was the most caloric, because it contained more fat. From the point of view of consumer characteristics, the optimal ratio of protein and fat was noted in the dorsal-rib and sacral part of the cut in the meat of foals of Megezhekskaya and Yakut breeds, and in the Prilenskaya in the brisket. As a result of the conducted studies on the growth and development of horses of different breeds, as well as on the qualitative assessment of young horse meat obtained from foals of different breeds in the Republic of Sakha (Yakutia), it has been found that from foals of Prilenskaya and Megezhekskaya breeds, in comparison with the original Yakut breed, higher quality horse meat was obtained. With the average selling price of 1 kg of live weight of 22,8 thousand rubles, additional cash income is provided for breeding horses of Prilenskaya breed in the amount of 79,4 million rubles, and Megezhekskaya breed 56,0 million rubles compared to the original Yakut breed.

FETAL ANATOMY OF THE HUMAN SPINAL CORD

Due to the development and improvement of medical technologies and diagnostic methods, in recent years, the interest of neuromorphologists, neuropathologists, neurosurgeons and reproductive specialists in the histogenesis of the structures of the central nervous system, in particular, the spinal cord, has increased. In the process of macro- and microscopic examination of the spinal cord of human fetuses of 20-21 weeks of intrauterine development, the topography of the thickenings in relation to the parts of the spinal column was established according to our own method, the morphometric parameters of the structures of the spinal cord segments and the regularities of cytoarchitectonics were determined. In 20-21 week old fetuses, the ratio of the length of the spine to the parietococcygeal length of the fetus is 65.0%, and the ratio of the length of the spinal cord to the parietococcygeal length of the fetus is 54.0 %. The border between the cervical and thoracic spine is projected onto a conditional line that connects the spine of the scapula. The border between the thoracic and lumbar regions of the spine is the line between the upper three quarters and the lower one quarter of the body length. The border between the lumbar and sacral parts runs along a conventionally drawn line that connects the posterior lower iliac spines, and the border of the transition of the sacral to the coccygeal is the level of the lower third of the gluteal region. The structure of the gray matter of the spinal cord segments in this age period corresponds to that in people of mature age – the presence of anterior, lateral and posterior horns. A large area of gray matter is observed in the cervical and lumbar segments, a smaller area in the thoracic and sacral segments. The structuredness of the white matter of the spinal cord segments in this age period corresponds to that in adults – the presence of anterior, lateral and posterior cords. The cervical and lumbar segments have a large area of white matter, and in magnitude they are the same. The nuclei of radial glial cells are relatively equal in size in all segments. The thickness of the matrix layer varies throughout the entire spinal cord, but reaches its greatest size in the ventral parts. The sizes of the nuclei of neuroblasts also fluctuate: the nuclei of motor neurons have large sizes, and the smaller ones are inserted and vegetative. The nuclei of glial cells have relatively identical sizes of different segments of the spinal cord, but 2-3 times less than the nuclei of neuroblasts.

To the question of diseases of the conusmedullaris and the sacral part of the spinal cord

The suffering of the lower spinal cord and caudae equinae have recently attracted the attention of researchers, and observations related to this issue are now carefully collected and described everywhere. Thanks to this, the range of our information has significantly expanded both 1) in relation to the determination of the level of damage, and 2) in relation to the differential diagnosis between the suffering of the spinal cord itself and damage to the corresponding roots. First of all, with regard to the first point, Raymond proposed for clinical purposes a more precise border of the cerebral cone, to which, in addition to the established anatomical boundaries, he also included the part of the medullae sacralis, which lies below the exit of the III sacral root. Damage to this part of the spinal cord is caused by a completely definite complex of symptoms, which is composed of: paralysis of the bladder and rectum, disorders in the male reproductive apparatus and limited anesthesia not only of the mucous membranes of the mentioned organs, but also of the perineum, the circumference of the ani and the lower sciatic region thigh surface.

The use of Kinesiology Taping among people aged between 25 and 55 with the non-specific pain of spine in its lumbar and sacral part

INTRODUCTION. The phenomenon of the pain ailments of spine is very complex and increasingly common. The key aspect of the treatment is the appropriate choice of the therapy, which may be dependent on many factors i.e.: the cause of the ailments, the phase of the disease, the clinical sypmtoms, the general health condition of the patient, the functional disorders and the patient's abbilities. &#x0D; AIM OF THE RESEARCH. The aim of the research is the assessment and the comparison of the effects of two methods of the treatment: 1) the therapy based on general exercises focused on the lumbosacral spine combined with Kinesiology Taping and 2) the therapy based on general exercises focused on the pain intensisty and on the life quality of people with chronic, non-specific pain of the lumbosacral spine among patients aged 25-55.&#x0D; MATERIALS AND METHODOLOGY. The research was conducted in a group of 50 people with chronic spine pain in the lumbosacral area. They were randomly divided into two groups: 1) the study group, where the ligament application of Kinesiology Taping was used for seven days (KT+GE), 2) the control group: no appliation of Kinesiology Taping (GE). Both groups took general exercises commonly used in the treatment of non-specific pain ailments of the lumbosacral spine for seven days. Durring the assessment of the effectiveness of the therapy the NRS scale (Numerical Rating Scale)and the Oswestry Low Back Pain Disability Scale questionnaire were used.&#x0D; RESULTS. At the end of the treatment in the KT+GE group the decrease of the average pain intensity was observed from 6,20 to 2,12 (median 6,00 vs 2,00). The decrease of the average pain intensity was also noted in the GE group from 6,20 to 3,48 (median 6,00 vs 4,00). The statistical analysis showed that both forms of the therapy had a statistically significant impact (p

ROLE OF PUBIS IN SEXUAL DIMORPHISM OF HIP BONE - A MORPHOMETRIC STUDY IN NORTH INDIAN POPULATION

Introduction: Sex estimation of skeletal remains is an important issue in both forensics and bioarchaeology. Many mammalian species display sexual dimorphism in the pelvis, where females possess larger dimensions of the obstetric canal than males. This is contrary to the general pattern of body size dimorphism, where males are larger than females. Pelvic dimorphism is often attributed to selection relating to parturition, or as a developmental consequence of secondary sexual differentiation. Current opinion regards the hip bone as the most reliable sex indicator because it is the most dimorphic bone, particularly in adult individuals. Material & Methods: In the present study, an attempt has been made to find the base line data of thirteen parameters pertaining to ilia of 100 hip bones of known sex and side. Variables studied were: Total length of iliac crest, lengths of its ventral & dorsal segments; distance between Anterior Superior Iliac Spine & Iliac Tubercle; Iliac height; Ventral, Sacral, Direct, Lower & Upper iliac heights; Iliac breadth; Lower, Ventral & Sacral iliac breadths, Length of pelvic & sacral parts of Chilotic Line. Results: The results obtained were tabulated, statistically analysed & compared to the earlier literature. It was seen that almost all the parameters except Sacral Iliac Height, Lower Iliac Height & Pelvic parts of Chilotic line were longer in males. Conclusion: To conclude, the morphometry of ilium also constitutes an important mean of sexual dimorphism. However its parameters are longer in males as it does not form a part of birth canal so is independent of sex hormones & is akin to general rule that male bones are larger than female bones.

A morphometric analysis of pedicles of lumbar vertebrae by using computed tomography scan

Background: The vertebral column is the central pillar of the body which has cervical, thoracic, lumbar, sacral and coccygeal parts. Out of these, the lumbar part is made up of five lumbar vertebrae which lies between the thoracic part above and the sacral part below. &#x0D; Objective: The study aimed to measure pedicle dimensions of lumbar vertebrae by using computed tomography scan.&#x0D; Methodology: This is a descriptive cross-sectional study which was conducted on 115 images of computed tomography scan collected from the Department of Radio-Diagnosis, Dhulikhel Hospital between May and October 2019 after receiving ethical approval from the Institutional Review Committee. All the scans available in the department were taken for the study. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data analysis was done in the Statistical Package for the Social Sciences version 16 (SPSS 16.0).&#x0D; Results: The pedicle chord length and breadth progressively decrease from L1 to L5 vertebral levels and pedicle thickness gradually increases from L1 to L5 vertebrae on both sides in both genders. The pedicle chord lengths were found significantly different whereas breadth and thickness were insignificantly different between males and females at all lumbar vertebral levels except at L1 for breadth.&#x0D; Conclusions: The pedicle chord length and breadth gradually decreases whereas thickness increases from L1 to L5 vertebral levels amongst Nepalese population.

Клінічний підхід щодо діагностики та лікування асоціативних дерматитів у котів

As a result of the studies it was found that associative dermatitis in cats has a complex etiological nature, which is associated with the active influence of the multifactorial system of pathogens, primarily of the parasitic-fungal profile. Collecting the primary history data, it was found that 29 cats (37.18 ± 3.15%) of the total number of animals examined had local skin lesions (head, auricles, distal extremities, lumbar and sacral parts) and severe itching, and 13 animals (16.67 ± 2.36%) had generalized lesions (miliary dermatitis). Diagnostic tests that were performed revealed the etiological factor of skin pathologies in the examined cats (Felicola subrostratus (Burmeister, 1838) and Microsporum canis (Bodin ex Gueg, 1902). Clinical signs with trichodectosis-dermatophytosis dermatitis were characterized by clear foci of inflammation, hypotrichosis, the presence of seborrhea and severe allopecia in the muzzle (around the eyes, mouth), on the ventral surface of the neck, groin and abdomen. Itching was pronounced (8 points) Diagnostic criteria for trichodectosis-dermatophytosis dermatitis included anamnesis, animal response to previous treatment, animal welfare conditions (flat or free-range), contagiousness for other people and animals (microscopic examination of hair, deep scrapings, cytological studies, elimination diet, skin biopsy and endocrine tests). Differential diagnosis is aimed at eliminating a number of diseases that are accompanied by clinical symptoms of skin and hair damage, namely: allergic flea dermatitis, food allergies, atopic dermatitis, heletheliosis, malassesiosis dermatitis, leishmaniasis, demodecosis, atypical skin form of cryptococcosis, sarcoptosis. Treatment for associative trichodectosis-dermatophytosis dermatitis included the use of topical preparations (Imaverol, shampoo with chlorhexidine 4%, Leka derm ointment, systemic fungicides (terbinafine), glucocorticosteroids (prednisone) and Royal Canin Sensitivity S veterinary diets Feline. The main components of prevention and control in associative dermatitis in cats were the mechanical cleaning and disinfection of rooms (neostomazane, Parastop aerosol), where animals were kept. It is recommended for animal owners to carry out systematic treatment of animals from ectoparasites (once in 3 months) with antiparasitic agents (drops, sprays, collars).

136. Biomechanical study of the sacral replacement part as a model for spinopelvic reconstruction following total sacrectomy

BACKGROUND CONTEXT Total sacrectomy is usually performed when a sacral tumor involves high-level sacral vertebra. Following total sacrectomy, the continuity between the spine and pelvis is necessary for ambulation, and to enable patients to resume daily living activities sooner during rehabilitation. PURPOSE The aim of this study is to assess the biomechanical properties of a novel spinopelvic reconstruction system following total sacrectomy: a sacral solid porous titanium replacement part manufactured through a rapid prototyping technique (EBM, electron beam melting). STUDY DESIGN/SETTING Biomechanic study. METHODS Three studies were carried out: with finite element methods (FEM), fatigue with a polyamide model, and in cadaver. The following models were compared in the FEM study: (1) two connected rods in L, L3-L5 pedicle screws, and two bilateral iliac screws; (2) Model 1 with no L3 fixation; (3) two connected rods in L, two screws to the L5 body and L3-L5 pedicle screws; (4) Model 3 with no L3 fixation; (5) sacral replacement part connected to the L5 body with two screws and two bilateral iliac screws, pedicle screws in L4-L5, and two vertical rods that connect them to the part; (6) Model 5 with a trans-iliac fixation rod. The L5 (mm) vertical drop, the Von Mises stress (Nm), and stress distribution were assessed. In the other studies, Model 5 was evaluated, checking the existence of errors in the instrumentation. RESULTS The areas of maximum stress were located in the connection between L5 and the pelvis in all the models. No errors were detected in the fatigue with a polyamide model studies nor in cadaver. CONCLUSIONS Significant reductions of tension and vertical displacements were achieved with the sacral replacement part as well as the lowest values published to date; this indicates that the assembly is rigid and stable, preventing the collapse of the spine on the pelvis. With the tensions obtained with the replacement part–112 MPa there is no risk of breaking when exposed to static loads nor fatigue behavior of the implants, as opposed to the other assessed and published models. Once implanted, the replacement part could show good behavior by reconstructing the anterior spine, preventing overloads in the spine or pelvis, increasing fusion rates, potentially reducing the number of check-up surgeries due to instrumental breaking down, and allowing early mobilization of the patient. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Great Panathenaia in Greek drama

The works of the Greek playwrights of the classical period are an interesting source on the history of the panatheniac festival. The tragedies of Aeschylus, Sophocles, Euripides, and the comedies of Aristophanes contain information about both the sacred part of the Great Panathenaia and agones the Panathenaic games. Of the elements of the sacral part of the Panathenaic festival were most often mentioned holiday peplos for Athena, the participants of the Panathenaic procession, the night procession, sacrifi ce. Part of the Panathenaic games were both in agony, which is characteristic for the Panhellenic games available for the citizens of Greece and local competitions, participation in which was limited only to the citizens of Athens. The mention of agones inherent in the Panhellenic games can be found in many works of Greek playwrights, but nowhere is there a clarifi cation that we are talking about the Panathenaic games. But it is interesting to note that more mentioned in the tragedies, and especially in the comedies of Aristophanes local competitions, which were sacred.

The characteristic features of vertebral lesions in the victims of a road traffic accident with intrusion into the passenger car compartment

The objective of the present study was to develop the diagnostic criteria for determining the positions of the participants of a road traffic accident inside the passenger car compartment based on the analysis of the characteristic features of vertebral lesions in the victims. The archival documents of forensic medical expertises were used to analyze the specific characteristics of fractured cervical vertebra in the victims of the accident inside the passenger car compartments including the drivers (n=92), the occupants of the forward (n=43) and rear (n=37) seats of the car. Localization and mechanisms behind the formation of vertebral lesions in the cervical part of the spinal column associated with the intra-compartment injury is of primary importance for the diagnostic purposes. The character of an injury to the cervical region gives evidence of the position of the driver and the occupants of the car inside the passenger compartment at the moment of the accident. Injuries to the cervical, thoracic, and/or sacral vertebrae may be indicative of the seat (either driver's, forward or rear) occupied by the victim(s). The fractures of the sacral part of the vertebral column are of negligible value for the differential diagnostics between the positions of the driver and/or other victims because they equally frequently occur in the drivers and occupants of both the forward and rear seats. Nevertheless, the proposed criteria made it possible to construct the mathematical model in the form of the logistic regression equations and to use them for making the probabilistic predictions as regards the positions of the participants of a road traffic accident inside the passenger car compartment based on the selected combination of pathomorphological characteristics in the victims.

СТИМУЛЯЦИОННАЯ ЭЛЕКТРОНЕЙРОМИОГРАФИЯ В ДИАГНОСТИКЕ ПРОФЕССИОНАЛЬНОЙ ВЕРТЕБРОГЕННОЙ ПОЯСНИЧНО-КРЕСТЦОВОЙ ПАТОЛОГИИ У ТРАКТОРИСТОВ

We studied the functional state of the neuro-muscular area – the lumbar and sacral part of the backbone in tractor operators using the stimulating electroneuromyography (SENMG) metod. Analysis of bioelectric activity of muscules and peripheral nerves was done. The electroneuromyographic changes revealed that functional motor-neuron inhibition is due to reflectory disorders. It has been shown that there is a relationship between vertebral pathology of the lumbar-sacral area and length of work.

SAPHO syndrome the therapeutical challenge

Introduction: Sapho syndrome is a syndrome characterizing with osteoarticular end dermatologic symptoms. Acronym 'SAPHO' means: S-Sinovitis, A-Acne, H-Hyperostosis, O-Osteytis. SAPHO syndrome has a 50 different names in existing literature. For now, etiology remains unclear, but it belongs to group of seronegative spondylarthropathies. Therapy of SAPHO includes NSAIL, glucocorticosteroids, disease modifying anthireumatic drugs (DMARD), antibiotics, bifosfonatos, and anti TNF - alfa drugs with variable success. Case outline: Patient P.Z, 47 age, female, comes in the hospital, because of pain in anterior chest, with propagation in right arm, end morning stiffness in sacral part, which passes short after. Also, with recidivant pustules on the palms, bilaterally, which precedes itch. Bone scintigraphy was performed: There is a clear increasing binding of radiopharmacs in projection of strenoclavicular joint, and slightly in both shoulders and both knees. HP: Pustulosis palmoplantaris. We introduced in therapy azithromycin in the dose of 500 mg, two times weekly, for 16 weeks. Patient, one year after, is without relapses of arthritis and skin lesions. Conclusion: This report has goal, to get more knowledge about this rare disease, and to be easier for recognition. Also we want to introduce other physicians, of varying specialities, like orthopaedics, and other surgeries, with this disease, not only rheumatologists, dermatologists, and pediatrics.

Properties of norm and variability

Data of the authors from many years on the two ways of development of a group of offspring of tailless amphibians--development with the effect of the norm of characteristics and development with the effect of mass anomalies of a number of characteristics--are summarized. Mass anomalies of limbs in the African clawed frog Xenopus laevis were obtained in laboratory (without using any special influences). They represent a syndrome when the structure of limbs and their girdles, as well as the sacral part of the spine, change correlatively. The syndrome has several stages of manifestation (according to the degree of intensification of deviations from the norm). The maximum manifestation of the syndrome produces a change in the norm of the structure of the sacral part. It was shown that change in the rule of its variability precedes change in the norm of the structure of the sacrum. Not having an opportunity of observing the process of evolution directly (change in norms on the large scale of time), we have to use any data (even indirect), which can give us information on how the change in the norm takes place and what happens to the variability.

An anatomic study of the interspinous space of the lumbosacral spine

The purpose of this study is to quantify the interspinous anatomy at the L4/5 and L5/S1 levels. One hundred reconstructed computer tomography scans of the lumbosacral spine were reviewed by two separate surgeons. Data were collected from the midline sagittal reconstructed image at the L4-5 and L5-S1 levels. Measurements obtained included the disc angle, anterior and posterior disc height, and maximum interspinous space in both the anterior-posterior and cephalad-caudal directions. The disc height and disc angle were correlated with the interspinous height. The mean age of the patients reviewed was 47years (range: 16-91; standard deviation: 20). According to our data population, the average length of the interspinous space was larger at the L4-5 level (13mm) than the L5-S1 level (9mm). The interspinous height was similar between the two levels. A poor correlation existed between the disc height or disc angle and the interspinous height. There was no correlation between measurements and age. The interspinous space available, as defined by computer tomography, at the L5/S1 level, is less able to accommodate current interspinous devices compared to the adjacent L4/5 level. The limiting factor is the length of the sacral part of the L5-S1 interspinous space.