Sagittal Diameter Research Articles

Radiologic Examination of High Riding Vertebral Artery and Analysis of Secure Areas

ObjectiveTo radiologically examine the pedicle, lamina, and vertebral artery foraminal anatomies at the C2 vertebra for pedicular and laminar screw instrumentation at the axis in a Turkish population. Materials and MethodsFrom 2018 to 2019, we evaluated 100 patients who underwent cervical computed tomography (CT) for various reasons (excluding cervical pathologies) at Marmara University Hospital. The C2 pedicles were measured on CT images using measurement tools. In addition, axial computed tomography was performed at 0.1-mm intervals. Bilateral measurements were performed for each case. ResultsThe median right and left pedicle axial diameters were respectively 5.01 and 5.09 mm for the male patients and 4.31 and 4.38 mm for the female patients, showing a statistically significant difference between the sexes (p < 0.01). Of the patients, 15% had narrow pedicles. The pedicle sagittal diameters were smaller than 5 mm in 30% of the computed tomographic series. The internal height was <2 mm in 4% of the cases. ConclusionOur findings suggest significant individual and sex-related differences. Vertebral artery groove anomalies are commonly observed. Before performing a posterior craniocervical instrumentation surgery, a CT examination is beneficial because high-riding vertebral arteries must be kept in mind in determining the appropriate screw diameter and screw trajectory.

A Novel Predictor of the Length and Size of ACL Grafts in Chinese Han Adults for ACL Reconstruction: An MRI Study.

Currently, there is no simple and valid method to predict the length and size of the native anterior cruciate ligament (ACL) in each adult patient who will undergo ACL reconstruction. This study aimed to develop an imaging prediction method that can predict the length and size of ACL grafts using the intact posterior cruciate ligament (PCL), in order to enhance the graft preparation individualized sizing. Three hundred and nineteen patients aged 18 years or older who underwent magnetic resonance imaging (MRI) of the knee at an orthopaedic clinic between September 9, 2021, and February 5, 2023, were included. The length, sagittal diameter, and coronal diameter of the ACL and PCL were measured in all patients, and F-test were performed to explore linear relationship between ligament measurements. Equations were established to predict a variable of the native ACL for the corresponding variable of the intact PCL (i.e., sagittal diameter of the ACL = 4.32 + 1.08 × sagittal diameter of the PCL, and coronal diameter of the ACL = 2.45 + 0.59 × coronal diameter of the PCL, length of the male ACL = 10.92 + 0.64 × length of the male PCL, length of the female ACL = 11.76 + 0.58 × length of the female PCL) (R2 = 0.532; R2 = 0.417; R2 = 0.488; R2 = 0.509; respectively). The length and size of the intact PCL in cases without PCL buckling are predictors of the length and size of the native ACL in adults, respectively. The use of this information to optimize graft diameter may lower the rates of ACL graft failure in the future.

Correlation of serum uric acid levels with certain anthropometric parameters in prediabetic and drug-naive diabetic subjects.

Uric acid is produced during the metabolism of nucleotide and adenosine triphosphate and contains the final product of human purine metabolism. It acts both as an antioxidant and pro-inflammatory marker and has a positive association with visceral fat in overweight subjects. The aim of the present study is to find an association of uric acid level with certain anthropometric parameters in subjects having type 2 diabetes. The study included 124 urban drug-naive diabetic Indian subjects above 18 years of age from the general population of the city of North India. Uric acid concentrations were estimated by the uricase method. Fasting plasma glucose (FPG) concentrations were estimated by the glucose oxidase-peroxidase method. Anthropometric measurements and information on lifestyle factors and disease history were collected through in-person meeting. All participants of the study subjects had a body mass index (BMI) of more than 23.5. BMI, waist-to-hip ratio (WHR), waist-to-height ratio, waist circumference, neck circumference, weight, age, sagittal abdominal diameter (SAD), skinfold thickness, and body roundness index were positively correlated with the serum uric acid level. The correlation of weight, BMI, SAD, and WHR was statistically significant. We found that serum uric acid level increases as body fat content increases. Statistical data show remarkable results for a significant correlation of uric acid level with BMI, WHR, SAD, and FPG. Hypertrophy occurs as a result of inflammatory processes and oxidative stress when the supply of energy starts to exceed the storage capacity of adipocytes, as a result, adipokines such as interleukin (IL)-1, IL-6, and tumor-necrosis factor-alpha are released more frequently which lead to low-grade chronic inflammation. Uric acid levels are much lean toward visceral obesity than overall body fat content.

Anatomical and Morphometric Evaluation of the Third Trochanter in Dry Femurs

Abstract Aim: The objective of the study is to fill the gaps in knowledge about the third trochanter (TT) by quantifying these anatomical measurements and examining the morphological characteristics associated with its presence. Materials and Methods: The length, diameter, types, location, and distances to the greater and lesser trochanters of the third trochanter were determined. Measurements of the greater trochanter, lesser trochanter, and gluteal tubercle lengths and diameters of 144 femurs available in the Medical Faculty laboratory were taken using a digital caliper to calculate their relationships with the third trochanter (TT). Results: In our study of 144 dry femurs, we identified the presence of TTs in 25.35% of cases, which equates to 36 femurs. Notably, we observed significant gender differences in the prevalence of TTs, with 27 males having TTs compared to 9 females, indicating a higher occurrence of TTs in males (p= 0.027). Average femur length and width were 41.23 mm and 27.05 mm, Greater trochanter had dimensions of 45.27 mm by 38.66 mm, and lesser trochanter measured 24.89 mm by 17.78 mm. In TT-identified femurs, the TT had an average length and diameter of 39.46 mm and 26.01 mm, respectively. The study also provided measurements for gluteal tuberosity and trochanter distances, helping in orthopedic and anatomical research. Conclusion: In our study conducted on 144 dry femurs with sex determination using morphometric methods, it was found that the third trochanter (TT) was detected in 25.35% of the cases, showing significant sexual dimorphism in favor of males. These femurs exhibited specific morphological characteristics, including an increased superior sagittal diameter, elevated diaphysis platymetry index, and an enlarged greater trochanter. Additionally, the presence of the third trochanter may reflect adaptations to mechanical forces and evolutionary changes, making it a valuable trait for anatomical and genomic studies, as well as surgical procedures that require access to the femoral medullary cavity.

Contralateral approach using microscope and tubular retractor system for ipsilateral decompression of lumbar degenerative lateral recess stenosis associated with narrow spinal canal.

To summarize the clinical effect of a single-center retrospective analysis of the contralateral approach with a microscope and tubular retractor system for ipsilateral decompression in patients with lumbar lateral recess stenosis and a narrow spinal canal. A total of 25 patients who underwent ipsilateral decompression surgery via a contralateral approach with microscope and tubular retractor system, performed by one surgeon at a single center were retrospectively examined. The width of the lamina fenestration was compared with the preoperative distance from the root of the spinous process to the dorsal articular facet, the bilateral articular facet change in the suprapedicle notch section on CT scan, and with the changes in transverse and sagittal diameters of the canal area on MRI. Clinical efficacy was assessed using the Japanese Orthopedic Association (JOA), Visual Analog Scale (VAS), and Oswestry Disability Index (ODI) scores. In total, 25 patients were treated and the mean intraoperative time was 82.04 ± 12.48 min. There was no nerve injury, cerebrospinal fluid leakage, and infection complications. The postoperative CT revealed that the width of the contralateral laminar fenestration was less than the distance from the root of the spinous process to the dorsal articular facet. The residual widths of the ipsilateral articular facet and contralateral articular facet were greater than 2/3 of the preoperative articular facet width. The transverse and sagittal diameter of canal were significantly increased. The mean follow-up period was 12-16 months, and no recurrence or reoperation incidence were found at the last follow-up. When compared to pre-surgery, the ODI, VAS, and JOA scores were significantly improved after surgery (p < 0.05). Based on our single-center retrospective observation of 25 cases and combined with previous literature, the contralateral approach with a microscope and tubular retractor system for ipsilateral decompression in patients with lumbar lateral recess stenosis and a narrow spinal canal can reduce damage to the articular processes, and probably more conducive to the postoperative stability of the lumbar spine. This was a single center retrospective analysis with a small sample size and lacked randomized controlled trials (RCTs). However, larger-scale, multicenter RTCs are required for additional validation.

Morphometric Study of the Mastoid Process and its Role in Sex Differentiation: A Nigerian Computed Tomography Study

Abstract Background: The mastoid process can be utilized in forensic identification due to its resistance to alterations and population variations in its morphology. The study investigated the role of mastoid parameters in the determination of sex in a Nigerian population. Aims and Objectives: The aim of this study was to determine the gender differences in measurements of the mastoid process. Furthermore, the study aimed at assessing the percentage accuracy of using the mastoid variables in sex discrimination. Materials and Methods: This cross-sectional study used computed tomographic images of the brain, stored in the radiology unit of a referral hospital in Delta State, Nigeria. Permission was granted by the hospital’s Ethics Board. The measurements of the mastoid process were taken on images of 310 patients (170 males and 140 females) aged 20–80 years. Data were summarized using means and standard deviations. Gender, side, and age group comparisons were assessed using the independent t-test, paired t-test, and analysis of variance, respectively. The association between variables was probed using Pearson’s correlation test. The discriminant function analysis was used to determine the accuracy of correct sex allocation. The probability value was set at &lt;0.05. Results: All the measurements were larger in males than in females (P &lt; 0.05). All except the conventional height, oblique sagittal diameter, and mediolateral inclination angle showed significant differences between age groups (P &lt; 0.05). The true height and oblique coronal diameter showed a significant positive correlation with age (0 &lt;r&lt; 0.05) (P &lt; 0.05). The lateral intermastoid distance was the best sex-discriminating variable (89.4%). Using all nine variables, the accuracy of sex prediction was 89.7%. Conclusion: The sexually dimorphic mastoid dimensions can collectively be used for sex determination with acceptable accuracies, in cases where only the fragmented parts of the temporal bone are available in Delta State, Nigeria.

The Effect of Flexitarian Diet on Waist Circumference and Sagittal Abdominal Diameter (SAD) in Obese Female Students

&#x0D; Latar Belakang: Obesitas sentral menyebabkan berbagai penyakit. Lemak perut dikaitkan dengan gangguan metabolisme. Intervensi diet yang menargetkan lemak perut dilaporkan memiliki manfaat kesehatan. Pola makan nabati diketahui bermanfaat dalam mengurangi lemak perut.&#x0D; Tujuan: Penelitian ini bertujuan untuk melihat pengaruh diet flexitarian terhadap lemak perut melalui lingkar pinggang dan diameter sagital perut (SAD).&#x0D; Metode: Penelitian ini menggunakan quasi eksperimen dengan desain pre-post test control group design. Jumlah subjek penelitian adalah 21 siswi obesitas berusia 19-25 tahun di Semarang. Subyek dipilih dengan menggunakan metode consecutive sampling dan dibagi menjadi kelompok perlakuan dan kelompok kontrol. Kelompok perlakuan diberikan edukasi dan diet fleksibel selama 4 minggu, sedangkan kelompok kontrol diberikan edukasi. Data antropometri diambil sebelum dan sesudah intervensi. Analisis statistik dilakukan dengan uji-t berpasangan, uji-t independen, Mann Whitney, dan ANCOVA.&#x0D; Hasil: Asupan antar kelompok selama intervensi yang menunjukkan perbedaan statistik adalah energi, lemak, dan serat. SAD antara kelompok perlakuan (-1,2±0,6cm) dan kelompok kontrol (0,2±1,5cm) menunjukkan perbedaan yang bermakna (p=0,010). Tidak ada perbedaan bermakna lingkar pinggang antar kelompok, namun penurunan pada kelompok perlakuan lebih besar (-6,6±5,5cm). Aktivitas fisik tidak mempengaruhi perubahan SAD (p=0,210), sedangkan perlakuan diet mempengaruhi perubahan SAD (p=0,010).&#x0D; Kesimpulan: Perubahan SAD menunjukkan perbedaan yang signifikan antara kelompok setelah intervensi. Perubahan lingkar pinggang tidak signifikan antar kelompok, namun penurunan lebih besar pada kelompok perlakuan.&#x0D;

Morphometric study of the lumbar vertebrae in dried anatomical collections

Background The objective of this anatomical study was to perform the morphometry of dried lumbar vertebrae in human cadavers. Methods This study utilized 200 adult human cadaveric dried lumbar vertebrae. The digital Vernier calipers was used to perform the measurements. The height, antero-posterior length, transverse length of the body of the vertebrae, interpedicular distance at the lateral ends, lamina length, height and thickness, superior and inferior articular facet height and width, mid sagittal and transverse diameter of vertebral foramen, height, width and thickness of the pars inter-articularis were measured. Results The vertebral body’s anteroposterior length was more at the lower border than at the superior border (p &lt; 0.01). The length of lamina was higher over the right in comparison to the left (p &lt; 0.001). The height of lamina, width of inferior articular facet, diameter of lateral recess and thickness of pars inter-articularis were greater for the left sided specimens (p &lt; 0.01). The statistical significance was not observed for the comparison of the remaining parameters (p &gt; 0.05). Conclusion This anatomical study offered several dimensions of lumbar vertebrae, which are essential in the surgical practice. The implants at the lumbar vertebrae need to be manufactured based on the anatomical dimensions of that particular sample population.

Keyhole Fenestration for Cerebrospinal Fluid Leaks in the Thoracic Spine: Quantification of Bone Removal and Microsurgical Anatomy

BACKGROUND AND OBJECTIVE: A safe working trajectory is mandatory for spinal pathologies, especially in the midline, anterior to the spinal cord. For thoracic cerebrospinal fluid (CSF) leaks, we developed a minimally invasive keyhole fenestration. This study investigates the necessary bone removal for sufficient exposure of different leak types particularly regarding weight-bearing structures. METHODS: In this retrospective case series between January 2022 and June 2023, the volume of bone resection and the axial and sagittal diameter of hemilamina defects after closure through keyhole fenestration were quantified. The involvement of facet joints and pedicles was qualitatively rated. Demographic (age, sex, body mass index, leak type) and surgical data (blood loss, surgery time, discharge after surgery) and complications were analyzed. RESULTS: Thirty-three patients with 34 approaches were included. The volume of resected bone was 1.5 cm3, and the diameter of the hemilamina defect was 17.8 mm in the sagittal and 15.1 mm in the axial plane. Facet joints were uninvolved in 24% and partly resected in 74%, and one facet joint was resected completely. Pedicles remained intact in 71% and were minimally involved in 29%. The median surgery time was 93 minutes, blood loss was 45 mL, and discharge was 4 days after surgery. Three patients (9%) needed revision surgery. No relevant and persisting morbidity occurred. Within the median follow-up period of 10 months, no stabilizing surgery was necessary. No permanent neurological deficit occurred. CONCLUSION: The keyhole fenestration leaves weight-bearing structures like facet joints and pedicles intact in most cases. The limited, penny-sized bone resection is sufficient to reach and close thoracic CSF leaks Type 1, 2, and 3 from the anterior midline to the ganglion. For experienced centers, it is a universal minimally invasive approach for treating all CSF leaks.

Stand-Alone Percutaneous Pedicle Screw Lumbar Fixation to Indirectly Decompress the Neural Elements in Spinal Stenosis: A Radiographic Assessment Case Series.

The ideal surgical treatment of lumbar canal stenosis remains controversial. Although decompressive open surgery has been widely used with good clinical outcome, minimally invasive indirect decompression techniques have been developed to avoid the complications associated with open approaches. The purpose of this study was to evaluate the radiologic outcome and safety of the indirect decompression achieved with stand-alone percutaneous pedicle screw fixation in the surgical treatment of lumbar degenerative pathologies. Twenty-eight patients presenting with spinal degenerative diseases including concomitant central and/or lateral stenosis were treated with stand-alone percutaneous pedicle screw fixation. Radiographic measurements were made on axial and sagittal magnetic resonance (MR) images, performed before surgery and after a mean follow-up period of 25.2 months. Measurements included spinal canal and foraminal areas, and anteroposterior canal diameter. Percutaneous screw fixation was performed in 35 spinal levels. Measurements on the follow-up MR images showed statistically significant increase in the cross-sectional area of the spinal canal and the neural foramen, from a mean of 88.22 and 61.05 mm2 preoperatively to 141.52 and 92.18 mm2 at final follow-up, respectively. The sagittal central canal diameter increased from a mean of 4.9 to 9.1 mm at final follow-up. Visual analog scale (VAS) pain score and Oswestry Disability Index (ODI) both improved significantly after surgery (p < 0.0001). Stand-alone percutaneous pedicle screw fixation is a safe and effective technique for indirect decompression of the spinal canal and neural foramina in lumbar degenerative diseases. This minimally invasive technique may provide the necessary decompression in cases of common degenerative lumbar disorders with ligamentous stenosis.

Normative MRI for Lumbar Spinal Canal and Vertebral Body Dimensions in a Jordanian Population Sample

Aim: To provide normal values for the lumbar spinal canal, lumbar vertebral body and dural sac dimensions and canal body ratio by MRI for a Jordanian population sample.&#x0D; Material and methods: Three well trained observers reviewed 218 lumbar MRI scans performed between 2019–2021 (1090 lumbar levels) and obtained from the central computerized medical archive of three main governmental hospitals in north, central and south Jordan. All MRIs with alignment abnormalities (scoliosis and kyphosis), canal compression, vertebral disease (including fractures) or technical artifacts were excluded. The following were measured from L1 to L5 levels: the midsagittal diameters of the spinal canal and vertebral body, axial anteroposterior (AP), and transverse diameter of the vertebral body, dural canal and dural canal area. Data on sex and age were also documented.&#x0D; Results: The studied MRI scans included 113 males (51.8%) and 105 females (48.2%). Age ranged between 23–86 years old (mean 52.23 ± 13.125). The mid sagittal mid vertebral AP diameter of the lumbar spine range was 2.8–3.1 cm. The mid sagittal spinal canal diameter range was 1.3–1.5 cm. Canal body ratio was 3.3–3.6. The AP, transverse dural sac diameter ranges were 1.2–1.4 cm and 1.5–1.9 cm, respectively. Finally, the dural sac area ranged from 331–362 mm2.&#x0D; Conclusion: The dimensions of the lumbar spinal canal, vertebral bodies, and vertebral canal ratio at all levels were documented for a Jordanian population sample. Dimensions varied according to sex and when compared with other ethnic groups (Asian and African). The findings suggest that canal stenosis criteria should take these differences into consideration.

Morphometric study of cervical spinal canal and transverse foramen diameter using computed tomography: Sex difference and relationship to age in Turkish population.

Accurate and detailed spinal canal diameter transverse foraminal morphometry measurements are essential for understanding spinal column-related diseases and surgical planning, especially for transpedicular screw fixation. This is especially because lateral cervical radiographs do not provide accurate measurements. This retrospective study was conducted to measure the dimensions of the transverse foramen sagittal and transverse diameter (TFD), spinal canal diameter, the distance of the spinal canal from the transverse foramina at the C1 to C7 cervical level, and the anteroposterior and TFDs in the Turkish population. A total of 150 patients who underwent cervical spine computed tomographic imaging with a 1:1 gender ratio were enrolled in the study. The sagittal and TFDs of the spinal canal, the distance of the spinal canal from the transverse foramen, and anteroposterior and TFDs in both right and left sides for all cervical levels C1 to C7. Foramina transversal diameters were measured using imaging tools of the imaging software in the radiology unit. The mean age of the study group was 47.99 ± 18.65 (range, 18-80) years. The majority of the distances of the spinal canal from the transverse foramen and antero-posterior (AP) & transverse (T) diameters for cervical vertebrae were significantly higher in male patients (P < .05). However, between age groups, a few measurements were found significantly different. Some of the distances of the spinal canal from the transverse foramen were significantly higher on the right side whereas all AP & T diameters were significantly higher on the left side in both male and female patients (P < .05). Almost all measurements were significantly higher on the left side for younger patients (<65 years) whereas only AP & T diameters were significantly higher on the left side for older patients (>65 years) (P < .05). Computed tomographic imaging is better than conventional radiographs for the preoperative evaluation of the cervical spine and for a better understanding of cervical spine morphometry. Care must be taken during transpedicular screw fixation, especially in female subjects, more so at the C2, C4, and C6 levels due to decreased distance of the spinal canal from the transverse foramina.

MORPHOMETRIC STUDY OF THE LUMBAR VERTEBRAE PEDICLE IN DRY HUMAN BONES IN SOUTH INDIAN POPULATION

Objective: The present study is to demonstrate the morphometric measurement of the pedicle of lumbar vertebrae in dry human bones. In the vertebral column of the human body, the lumbar vertebrae are the biggest and most unfused vertebrae when compared to other vertebrae. The entire weight of the torso is supported by the vertebral column, and the whole body weight is transmitted through the lumbar spine. Because of this, the lower segment vertebrae are most susceptible to degenerative changes. Methods: This study was conducted in the Department of Anatomy at Villupuram Medical College under MGR University. The morphometric measurements of the 50 dry lumbar vertebrae were taken using vernier calipers. The parameters included in this study are pedicle sagittal diameter (pedicle height), interpedicular diameter, and external transverse diameter (pedicle width). SPSS software for Windows version 22.0 (IBM Corp., Armonk, NY) is used for statistical analysis. The data were analyzed and recorded. Results: The pedicle width was broadest at the L5 level. The narrowest pedicle width is at the L1 level. The external sagittal (pedicle height) diameter was broadest at the L1 level. The narrowest pedicle height was at the level of L5. The interpedicular diameter is maximum at the level of L5 and minimum at the level of L1. Conclusion: The increased use of internal fixation of pedicle screws makes the study of the morphometry of the pedicle of lumbar vertebrae important. Morphometry variations in the pedicle anatomy have been useful for orthopedic surgeons to choose the appropriate size of screws and angulations of screws.

Quantitative anatomy of the primary ossification center of the squamous part of temporal bone in the human fetus

Detailed numerical data about the development of primary ossification centers in human fetuses may influence both better evaluation and early detection of skeletal dysplasias, which are associated with delayed development and mineralization of ossification centers. To the best of our knowledge, this is the first report in the medical literature to morphometrically analyze the primary ossification center of the squamous part of temporal bone in human fetuses based on computed tomography imaging. The present study offers a precise quantitative foundation for ossification of the squamous part of temporal bone that may contribute to enhanced prenatal care and improved outcomes for fetuses with inherited cranial defects and skeletodysplasias. The examinations were carried out on 37 human fetuses of both sexes (16 males and 21 females) aged 18–30 weeks of gestation, which had been preserved in 10% neutral formalin solution. Using CT, digital image analysis software, 3D reconstruction and statistical methods, the size of the primary ossification center of the squamous part of temporal bone was evaluated. With neither sex nor laterality differences, the best-fit growth patterns for the primary ossification center of the squamous part of temporal bone was modelled by the linear function: y = −0.7270 + 0.7682 × age ± 1.256 for its vertical diameter, and the four-degree polynomial functions: y = 5.434 + 0.000019 × (age)4 ± 1.617 for its sagittal diameter, y = −4.086 + 0.00029 × (age)4 ± 2.230 for its projection surface area and y = −25.213 + 0.0004 × (age)4 ± 3.563 for its volume. The CT-based numerical data and growth patterns of the primary ossification center of the squamous part of temporal bone may serve as age-specific normative intervals of relevance for gynecologists, obstetricians, pediatricians and radiologists during screening ultrasound scans of fetuses. Our findings for the growing primary ossification center of the squamous part of temporal bone may be conducive in daily clinical practice, while ultrasonically monitoring normal fetal growth and screening for inherited cranial faults and skeletodysplasias.

Study on articular surface morphology of atlantoaxial lateral mass based on differential manifold

ObjectivesTo propose a surface reconstruction algorithm based on a differential manifold (a space with local Euclidean space properties), which can be used for processing of clinical images and for modeling of the atlantoaxial joint. To describe the ideal anatomy of the lateral atlantoaxial articular surface by measuring the anatomical data.MethodsComputed tomography data of 80 healthy subjects who underwent cervical spine examinations at our institution were collected between October 2019 and June 2022, including 46 males and 34 females, aged 37.8 ± 5.1 years (28–59 years). A differential manifold surface reconstruction algorithm was used to generate the model based on DICOM data derived by Vision PACS system. The lateral mass articular surface was measured and compared in terms of its sagittal diameter, transverse diameter, articular surface area, articular curvature and joint space height.ResultsThere was no statistically significant difference between left and right sides of the measured data in normal adults (P > 0.05). The atlantoaxial articular surface sagittal diameter length was (15.83 ± 1.85) and (16.22 ± 1.57) mm on average, respectively. The transverse diameter length of the articular surface was (16.29 ± 2.16) and (16.49 ± 1.84) mm. The lateral articular surface area was (166.53 ± 7.69) and (174.48 ± 6.73) mm2 and the curvature was (164.03 ± 5.27) and (153.23 ± 9.03)°, respectively. The joint space height was 3.05 ± 0.11mm, respectively. There is an irregular articular space in the lateral mass of atlantoaxial, and both upper and lower surfaces of the articular space are concave. A sagittal plane view shows that the inferior articular surface of the atlas is mainly concave above; however, the superior articular surface of the axis is mainly convex above. In the coronal plane, the inferior articular surface of the atlas is mostly concave above, with most concave vertices located in the medial region, and the superior articular surface of the axis is mainly concave below, with most convex vertices located centrally and laterally.ConclusionA differential manifold algorithm can effectively process atlantoaxial imaging data, fit and control mesh topology, and reconstruct curved surfaces to meet clinical measurement applications with high accuracy and efficiency; the articular surface of the lateral mass of atlantoaxial mass in normal adults has relatively constant sagittal diameter, transverse diameter and area. The distance difference between joint spaces is small, but the shape difference of articular surfaces differs greatly.

Evaluation of the effectiveness of the short-segment thoracolumbar instrumentation

Aims: This prospective study aimed to compare the long-term follow-up findings of patients with short-segment thoracolumbar instrumentation with the long-term follow-up findings results of patients with long-segment thoracolumbar instrumentation. Merthods: Patients who underwent surgery for a thoracolumbar junction spine fracture were included in this study. The patient's age, gender, and neurological impairment, "AOSpine Classification Scale", "Visual Analog Scale (VAS)", "modified Japanese Orthopedic Association (mJOA)" and "Oswestry Disability Index (ODI)" scores, pedicle and/or pars interarticularis fractures, anterior, middle, and posterior height loss of the fractured vertebral body (mm), the height loss rate of the fractured vertebra, angulation degree, sagittal and axial spinal canal diameters (mm) and presence of bone fragment extending into the spinal canal on CT images were recorded at admission to the hospital, and the end of the sixth month after surgical intervention. Duration of anesthesia and surgery time, the amount of bleeding during the surgery, the radiation level (mGy) released by fluoroscopy, performing laminectomy, length of stay in the intensive care unit, and hospital were recorded. Additionally, the stability and integrity of the instrumentation were examined with dynamic X-ray images. Results: Preoperative fractured vertebra collapse rates (t=4.175, p=0.001) and surgery times (t=4.175, p=0.001) were different between groups In the long-segment group, preoperative VAS scores (Z=-2.687, p=0.007), mJOA scores (Z=-2.585, p=0.010), and ODI scores (t=53.253, p&lt;0.001) were different from postoperative long-term follow-up values. In addition, in the short segment group, preoperative VAS scores (Z=-2.214, p=0.027), mJOA scores (Z=-2.333, p=0.020), and ODI scores (t=48.338, p&lt;0.001) were different from the postoperative long-term follow-up values. ROC-curve analysis and Logistic Regression analysis results revealed that any study parameter could not predict the decision-making for inserting screws into the fractured vertebra, the need for laminectomy, the risk of developing postoperative instability, or the worse prognosis risk of mJOA. Conclusion: This study's results showed that short-segment instrumentation, which is performed by inserting a screw into the fractured vertebra, is as effective as long-segment instrumentation in providing both clinical and radiological improvement in patients. At the same time, it has advantages such as less operating time, less surgical bleeding, and short anesthesia time. However, it was determined that no parameter of the study could predict the placement of screws in the fractured spine, the need for laminectomy, the risk of postoperative instability, or the prognosis risk of mJOA. Therefore, it was concluded that conducting this study on a larger patient population would be appropriate.

CT measurements of the proximal femoral medullary cavity in healthy adults: a cross-sectional study

Objective: To analyse the proximal femoral morphology on three-dimensional reconstructed imagery to explore the factors influencing the relevant parameters. Method: The cross-sectional study was conducted at Peking University Third Hospital in northern China from January 2019 to August 2020, and comprised healthy adults who underwent computed tomography scanning. Three-dimensional computed tomography reconstruction of the proximal femoral medullary cavity was performed using Mimics 22. The anatomical parameters related to total hip arthroplasty were measured to examine the relationship among gender, age and femoral length. Data was analysed using SPSS 20. Results: Of the 63 adults, meaning 126 hips, 21(33.3%) were males, meaning 42(33.3%) hips, and 42(66.6%) were females, meaning 84(66.6%) hips. The overall mean age was 51.5±23.1 years (range: 23-68 years). The inflection point of the medullary cavity curved at 5-10mm distal to the lesser trochanteric line. Most horizontal plane parameters significantly differed between men and women (p&lt;0.05), with the mean medullary cavity being wider in men than women. There was a significant difference between the genders in the sagittal anterior-posterior diameter of the canal flare index (p&lt;0.05). Age was negatively correlated with the coronal medial-lateral diameter and coronal lateral diameter of canal flare index. In the coronal and sagittal planes, there was a positive correlation between the metaphysis and diaphysis, and the coronal and sagittal planes were positively correlated with the orthogonal plane. Conclusions: Femoral morphology could be influenced by gender and age. Morphological changes of the proximal femoral medullary cavity were not present in a single plane, but were affected by multiple planes. When the diameter of one plane became larger, its orthogonal plane concomitantly increased. Key Words: Proximal femoral, Morphology, CT measurement, Correlation.

Rotator Cuff Tendon Dimensional Variability, Novel Patient-Specific Measurement Method—Morphological Measurement for Rotator Cuff Tendon

Introduction: The shoulder rotator cuff (RC) is crucial to shoulder function and involvement in shoulder pathology. RC tears have been extensively studied, and several classifications have been devised to quantify their magnitude. Various RC measurement techniques were introduced previously, utilizing cadaveric specimens, X-rays, CT scans, and MRI with different results published regarding humeral heads’ different plane diameters and the correlation to age, gender, and height. There are very few studies measuring RC length in the general population. Purpose: We aimed to assess the geometrical relation between rotator cuff tendon length and humeral head sagittal and axial diameters. Methods: A total of 100 shoulder MRI scans of labral tear-suspected patients were reviewed, and the geometrical parameters of the rotator cuff length and proximal humerus sagittal and axial diameters were measured. Results: The healthy population has wide variability in humeral diameter and rotator cuff length. We found a high correlation between humeral head sagittal and axial plane diameters and the rotator cuff tendon dimension. The orthogonal plane diameters disagree with the humeral head being round but rather spheric. The rotator cuff length changes according to the patient’s gender and height. Conclusion: This is a novel method for rotator cuff measurement, description, and classification according to the percentage of tear instead of length (cm). This method is more clinically oriented and relevant than most other previous methods.

Abdominal Fat is a Reliable Indicator of Lumbar Intervertebral Disc Degeneration than Body Mass Index

The objective of this study was to determine whether abdominal fat status correlates with low back pain (LBP) and lumbar intervertebral disc degeneration (IVDD) and to identify a new anthropometric index to predict the likelihood of developing LBP. Patients with chronic low back pain admitted to the Affiliated Hospital of Southwest Medical University from June 2022 to May 2023 were collected as the experimental group. Volunteers without LBP from June 2022 to May 2023 were also recruited as the control group. They underwent lumbar spine magnetic resonance imaging and had their body mass index (BMI) measured. Abdominal parameters were measured on T2-weighted median sagittal magnetic resonance imaging at the L3/4 level: abdominal diameter, sagittal abdominal diameter (SAD), and subcutaneous abdominal fat thickness (SAFT). Each lumbar IVDD was assessed using the Pfirrmann grading system. The differences in abdominal parameters and BMI between the experimental and control groups were compared, and the correlations between abdominal parameters, BMI, LBP, and IVDD were analyzed. Abdominal diameter, SAD, and SAFT had moderate-to-strong correlations with BMI. SAD was significantly associated with severe IVDD at L4-L5 and L5-S1 levels with odds ratio of 3.201 (95% confidence interval [CI]: 1.850-5.539, P<0.001) and 1.596 (95% CI: 1.072-2.378, P=0.021), respectively. BMI had no significant association with severe IVDD. In women, SAFT and BMI were significantly correlated with LBP; in men, only SAFT was significantly correlated with LBP. Appropriate cutoff values for men and women were 1.52cm (area under the curve=0.702, 95% CI: 0.615-0.789, P < 0.001) and 1.97cm (area under the curve=0.740, 95% CI: 0.662-0.818, P < 0.001), respectively. Men and women with SAFT of >1.52cm and >1.97cm, respectively, had significantly higher rates of LBP. SAD could predict severe IVDD better than BMI. SAFT is a better predictor of LBP than BMI, especially in men, and reliably distinguished patients with LBP from asymptomatic subjects with reliable cutoff values for men and women.

Sex Determination and Foramen Magnum Measurement (CT Study Case in Sulaimani Population)

Foramen magnum that is positioned under the sagittal suture and surrounded by the lateral, squamous, and basilar parts of the occipital bone is one of the most important structures in the base of the skull. Genetic, socioeconomic, and environmental factors have a significant impact on sexual dimorphism in F M dimensions which is population-specific. The present retrospective study was carried out in Sulaimani teaching hospital, Sulaimani, Iraq. The study sample consisted of 100 adult patients including 50 females and 50 males aged 20-70 years. All of the patients had CT scanned for their necks and heads over the period June 2017 to March 2019. In order to examine the foramen magnum, its sagittal diameter, transverse diameter, area, index, and circumference were measured. St udent’s t-test and histogram were used to analyze the data, and Receiver Operating Characteristic (ROC) curve and B inary Logistic Regression model were employed to obtain a model for sex determination. We found that women had a low er average value than men in our study. According to the independent t-test results; the genders were significantly different in terms of all measured parameters (p&lt;0.05). As demonstrated by the ROC curve, the predictability of the dimensions in sexing the crania for sagittal diameter, tr ansverse diameter, and area of foramen was respectively 76.0%, 66.0%, and 74.0%. The current study indicated a high per centage of sex predictability regarding the dimensions, areas, and circumference, which is because of the highly significant dif ference between the genders.