Vertebral Spine Research Articles

An Analysis of the Complication Reports of Expandable Lumbar Interbody Cages in the Food and Drug Administration Manufacturer and User Facility Device Experience Database.

Expandable lumbar interbody cages (ELICs) are commonly used for interbody fusion and provide lordotic correction by lengthening the anterior column of the vertebral spine. We sought to identify unique failure mechanisms and significant differences in the types of complications associated with ELICs as reported to the Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) Database. The MAUDE Database was analyzed for complication reports submitted for ELIC systems between January 2013 and July 2023. Reports were categorized by manufacturer, brand name, type of expandable cage, type of complication, year of complication, and reporter identity. Reports that were duplicated or had insufficient information were excluded from analysis. The top 5 manufacturers with the most implant-related complications were independently analyzed and compared. A total of 821 reports were analyzed. The top 5 complications reported across all manufacturers were cage breakage during insertion (25.7%), postoperative migration without collapse (16.0%), postoperative collapse (15.6%), inserter breakage (11.1%), and tubing problems (3.0%). A significant difference was detected in complication type between manufacturers (χ2=557, P<.001). The largest number of reports (120, 14.6%) was in 2016. With FDA approval of novel ELIC systems and the adoption of newer surgical techniques, understanding the range of potential complications is paramount in ensuring patient safety. This study of the MAUDE Database provides a comprehensive summary of adverse reported events associated with ELICs during the past decade. [Orthopedics. 202x;4x(x):xx-xx.].

Linfoma não Hodgkin da Zona Marginal Extranodal Tipo MALT com Acometimento da Coluna Torácica: revisão Sistemática da Literatura e Relato de Caso em um Hospital Universitário no Brasil

Background: Primary bone lymphomas are rare, accounting for less than 1% of non-Hodgkin's lymphomas (NHL). Extranodal marginal zone non-Hodgkin lymphoma of mucosa-associated lymphoid tissue (MALT) arising in the vertebral spine is extremely rare, with only seven cases reported. Methodology: A systematic literature review was conducted on cases from 2012 to 2022 of extranodal marginal zone MALT lymphoma involving the vertebral spine and associated with spinal cord compression. Additionally, a case report from a university hospital in Rio de Janeiro is described. The study was approved by the Research Ethics Committee (approval number: 5.818.416). Searches were performed in SciELO, PubMed, and LILACS databases, using the Health Sciences Descriptors: ("Vertebral Body" OR Spine) AND ("Lymphoma B-Cell Marginal Zone" OR "MALT Lymphoma" OR "Lymphoma of Mucosa Associated Lymphoid Tissue" OR "Mucosa Associated Lymphoid Tissue Lymphoma"). Articles with full texts available in English or Portuguese were selected. Case Description: A 56-year-old female presented with right-sided back pain, progressing to right flank irradiation, lower limb weakness (LLLL), and constitutional symptoms. MRI revealed a solid extradural mass occupying two-thirds of the vertebral canal's diameter, displacing and compressing the dorsal cord to the left. A bone marrow biopsy confirmed infiltration. Laminectomy was performed, and histopathology identified stage IVB extranodal marginal zone MALT lymphoma. Adjuvant chemotherapy led to complete remission. Results and Discussion: The literature review uncovered two relevant case reports. The thoracic spine was the most commonly affected region, and LLLL weakness was the most frequent symptom, with normal laboratory results. Treatment typically involved surgical tumor removal combined with radiotherapy or chemotherapy. Recurrence occurred in both cases, but follow-up showed no evidence of disease. The clinical presentation and exam findings of the current patient were similar to those in the literature, though with bone marrow infiltration. Treatment was consistent with cases in the review, with no recurrence to date. Conclusion: This case represents an uncommon manifestation of primary extranodal marginal zone MALT lymphoma with spinal cord compression, distinguished by bone marrow infiltration—a feature not previously reported in the two cases found in the literature. The case may be considered within the same group of cases reviewed.

Biostratigraphic significance of a new record of Protuberum cabralense, a bizarre traversodontid cynodont from the Middle‑Late Triassic of Southern Brazil

ABSTRACT Traversodontid cynodonts are one of the most abundant and diverse groups of tetrapods in the Triassic assemblages of Brazil. These cynodonts are distributed across four Brazilian Assemblage Zones (AZ), ranging from the late Ladinian to the early Norian. The most taxonomically diverse record comes from the Dinodontosaurus AZ, which has so far yielded at least six traversodontid genera. Among these taxa, Protuberum cabralense represents one of the most bizarre forms. This cynodont is characterised by the presence of enlarged and rounded protuberances along the dorsal surface of the ribs, the vertebral neural spines and dorsal portion of the iliac blades. These structures have been suggested to serve as a defensive mechanism or related to burrowing/digging habits. We report the first occurrence of P. cabralense at the Linha Várzea 1 site, located in the municipality of Paraíso do Sul, Brazil. This site is considered late Ladinian to early Carnian in age. The new material consists of five rib fragments, which possess the characteristic protuberances on their dorsal surface. A biostratigraphic investigation demonstrates the absence of P. cabralense in fossiliferous sites that yielded the cynodonts Luangwa. This observation contributes to the discussion regarding a potential subdivision within the Dinodontosaurus AZ.

New Ultrasound-Guided Approach to Access to the Posterolateral Part of Intervertebral Lumbar Discs: A Cadaveric Study.

Background: Approximately 40% of chronic low back pain patients have a discogenic origin. In relation to intervertebral disc injuries, most of them are in the posterior and lateral zone of the disc, involving the anterior lumbar roots and the spinal cord. Objective: The objective was to analyze and describe the accuracy and safety of a new ultrasound-guided approach to target the posterolateral part of the intervertebral lumbar discs in cadaveric specimens. Methods: A cross-anatomical study on sixty cadaver intervertebral lumbar discs was performed. A needle was introduced in the posterolateral part of the discs using ultrasound guidance. A transducer was placed in the anterior abdomen to visualize the discs in cross-section as well. A dissection of the specimen was performed to visualize the final position of the needle tip and its distance from the main lumbar structures. The angulation, length, and distance of the needle from the vertebral spine, the relevant ultrasound anatomical references, and the accuracy of the procedure were evaluated. Results: The needle tip reached the posterolateral part of the discs in 93.3% of the attempts. The mean length of the needle inserted was 79 ± 15 mm, the angulation 129 ± 20.2°, the distance from the spinous process was 77 ± 19 mm, and the distance of the needle to the nerve roots was 2.0 ± 1.2 mm. No statistically significant differences between genders were found. Conclusions: An ultrasound-guided technique can be an accurate and safe technique to perform invasive procedures on the posterolateral part of the intervertebral lumbar discs.

Ponticulus posticus and skeletal malocclusion: A pilot study in a Southern Italian pre-orthodontic court.

Ponticulus posticus (PP) is a bony protrusion located between the posterior portion of the superior articular process and the posterolateral portion of a posterior arch of the atlas vertebrae in the cervical spine. The aim of this study is to verify the presence of different types of PP in a Southern Italian pre-orthodontic cohort to understand its correlation with skeletal class and maturity. A case-control retrospective study was conducted, utilizing 212 latero-lateral telecranium radiographs to analyze skeletal maturity according to the cervical vertebral maturation method, the Angle's classification of malocclusion (I, II, or III), and the presence or absence of the PP, whether complete (c-PP) or partial (p-PP). A total of 212 lateral cephalograms were analyzed. Of the 72 male patients, 67 (93%) exhibited PP, and 116 (88%) were PP. The chi-square value was 0.001, while Cramer's V was 0.270, indicating a significant correlation between age groups and PP presence, and a very strong association overall. Out of the 41 complete PP cases, class I was notably more prevalent than classes II and III. Orthodontists should carefully consider PP when assessing and treating individuals with or without skeletal discrepancies and dental anomalies.

INCIDENTAL BONE METASTASIS FINDING FROM CT SIMULATION FOR BREAST CANCER RADIOTHERAPY

Breast cancer has the highest tendency for bone metastasis. This study aimed to evaluate bone metastasis using computed tomography (CT) simulation for breast cancer radiotherapy. We retrospectively reviewed the patient's CT images from September 2022 to February 2023. The median age was 48 (34–80), and almost half of the patients had T3-4 and N2-3 disease. Nine out of 53 patients (17%) had bone metastasis, and 8 had multiple lesions. The vertebral spine was the predominant site of bone metastasis. Due to the high rate of bone spreading, bone evaluation is mandatory during CT simulation for more appropriate treatment. Keywords: Bone metastasis, computed tomography, breast cancer

#2793 Improvement of bone mineral density in kidney transplant recipients: it is just denosumab?

Abstract Background and Aims Post-transplant bone disease is a common complication after a kidney transplant. Several factors, including pre-existing CKD-MBD, steroid, and CNI immunosuppressive treatment, contribute to this condition and increase the risk of bone loss and fractures. Among various therapeutic strategies, Denosumab, a human monoclonal antibody against RANK-L, can decrease the risk of fracture in Kidney Transplant Recipients (KTRs). The most reported side effects are episodes of hypocalcemia, which are associated with an increase in parathyroid hormone (PTH) levels. The FDA recommends treating these episodes with calcium supplements and cholecalciferol; another alternative is the use of receptor activators (VDRa). To our knowledge, there are only a few case reports in the literature analyzing the effect of combined treatment with VDRa and Denosumab. In this observational study, we evaluated changes in laboratory data and bone density (BMD) assessed by DXA in KTRs that received Denosumab with or without VDRa supplementation. Method This retrospective study evaluated 18 kidney transplant recipients who started Denosumab therapy after transplantation. The patients were divided into two groups: those who started or increased vitamin D receptor agonist therapy within the first 6 months before the second dose of Denosumab, and those who did not. We analyzed at baseline (T0) and after 1 year from first Denosumab administration (T1) creatinine, calcium, phosphate, PTH, bone alkaline phosphatase (BALP), osteocalcin (OC), carboxy-terminal cross-linked telopeptides of type 1 collagen (CTX), and 25-OH vitamin D and BMD at vertebral lumbar spine, femoral neck and total Hip. Furthermore, we evaluated Trabecular Bone Score (TBS). We performed ANOVA and Kruskal-Wallis for continuous variables based on distribution and Fisher's test for categorical variables. To assess the correlation between variables, we used linear regression and the Pearson correlation coefficient. Additionally, we conducted logistic regression to analyze the outcomes. Results A total of 18 patients were included in the study cohort. Of these, 66.7% were females, and 33.3% were males, with an average age of 67 years (Table 1). 13 patients started or uptitrated VDRa within the first 6 months (VDRa group), while 5 did not (Control group). At baseline, the VDRa group had a lower eGFR and higher PTH compared to the Control group, although both were at the threshold of statistical significance (37.38 vs 52.20 mL/min/1.73 m², p = 0.060 and 106.77 vs 72.60 pg/mL, p = 0.069). However, they had significantly lower serum calcium levels (8.96 vs 9.90 mg/dL, p = 0.039). In terms of baseline bone structure, there were no significant differences between the two groups at any of the three sites examined. At 1 year the VDRa group had a significantly greater gain at the Total Hip (+0.08 vs −0.03 g/cm3, p = 0.048 and +10.81 vs −4.16%, p = 0.037). Additionally, the VDRa group had an increase in TBS, while the Control group had a reduction, and this absolute and percentage variation between the two was statistically significant (+0.07 vs −0.02, p = 0.034 and +6.14 vs −1.62, p = 0.043) (Table 2). In linear correlation analysis higher doses of VDRa were significantly and positively associated with Delta BMD at the Total Hip (r = 0.65, p = 0.003). However, a significant correlation was highlighted between VDRa dosage and PTH reduction (r = −0.51, p = 0.027). Finally, in univariate logistic regression analysis, the dosage of VDRA was significantly and positively associated with 5% BMD gain at the Total Hip (OR = 1.54, CI 1.08 to 1.89, p = 0.046) (Fig. 1). Conclusion After conducting our study, we found that the use of Denosumab had a positive impact on bone mineral density. In addition to that, we observed that the association with VDRa led to further improvement in BMD and better control of PTH. Despite having a small sample size, our study demonstrates that VDRa not only helps in correcting hypocalcemia but also enhances the effect of Denosumab.

Generation and Validation of Normative, Age-Specific Reference Curves for Bone Strain Index in Women.

Bone Strain Index (BSI), based on dual-energy X-ray absorptiometry (DXA), is a densitometric index of bone strength of the femur and lumbar spine. Higher BSI values indicate a higher strain applied to bone, predisposing to higher fracture risk. This retrospective, multicentric study on Italian women reports the BSI normative age-specific reference curves. A cohort of Caucasian Italian women aged 20 to 90 years was selected from three different clinical centres. Bone mineral density (BMD) and BSI measurements were obtained for the lumbar spine vertebrae (L1-L4) and for the femur (neck, trochanter and intertrochanter) using Hologic densitometers scans. The data were compared with BMD normative values provided by the densitometer manufacturer. Then, the age-specific BSI curve for the femur and lumbar spine was generated. No significant difference was found between the BMD of the subjects in this study and BMD reference data provided by Hologic (p = 0.68 for femur and p = 0.90 for lumbar spine). Spine BSI values (L1-L4) increase by 84% between 20 and 90 years of age. The mean BSI of the total femur increases about 38% in the same age range. The BSI age-specific reference curve could help clinicians improve osteoporosis patient management, allowing an appropriate patient classification according to the bone resistance to the applied loads and fragility fracture risk assessment.

Isolated Transverse Process Fractures: Should We Offer Lumbar Corset or Not?

Background The aim of this study is to emphasize the need to be careful in terms of internal organ injuries in patients with isolated transverse process fracture (ITPF), and to investigate the effectiveness of corset use in controlling acute pain. Methods This is a retrospective study including 72 patients with only transverse process fractures secondary to trauma, who were admitted to the Emergency Department of Sakarya University Research and Training Hospital between January 2020 and October 2022. The radiological diagnoses were collected from spinal vertebral computed tomography images. Twelve patients were excluded from the study due to exclusion criteria. Sixty patients with ITPF were included in the comparison group. All patients were divided into two groups. The groupwith no lumbar corset (LC) included those who were discharged with analgesic and muscle relaxant treatment without a brace (n = 33). The LC+ group (n = 27) included those who received rigid lumbosacral orthosis in addition to analgesic and muscle relaxant treatment. Pain levels of all cases in both groups were evaluated with Visual Analog Scale scores on the day of trauma, the first week, the first month, and the sixth month. Results A total of 25 cases had one ITPF, 25 had two, 17 had three, and five patients had four or more ITPFs. The hospitalization rate was the highest among patients with four or more ITPFs (40%). Although the hospitalization rates according to the number of ITPFs were not statistically significant (p = 0.528), there was a clinical significance regarding increasing hospitalization rates with the increasing number of ITPFs. The hospitalization rates were 12%, 16%, 17.6%, and 40% in patients with one, two, three, and four or more ITPFs, respectively. Conclusion ITPFs should be treated conservatively. Concomitant organ injuries must be ruled out before treatment. Medical treatment without a lumbar corset could be used as a cost-effective choice.

Prevalence, distribution characteristic and risk factors of lumbar vertebral axial rotation in patients with lumbar disc herniation: a retrospective study

This retrospective study aimed to investigate the impact of lumbar disc herniation (LDH) on vertebral axial rotation (VAR) in the lumbar spine, focusing on both close and distant neighboring vertebrae. A total of 516 patients with LDH and an equal number of healthy individuals were included in the study, matched for age and gender. The degree of axial rotation for each lumbar spine vertebra was assessed using the Nash–Moe index. The results revealed that the prevalence of VAR in the lumbar spine was significantly higher in the LDH group compared to the Control group (65.7% vs 46.7%, P < 0.001). Among the LDH group, the L2 vertebra had the highest frequency of VAR (49.5%), followed by L1 (45.1%), and then L3 to L5 (33.6%, 8.9%, 3.1%, respectively). A similar pattern was observed in the Control group (L2, 39.8%; L1, 34.6%; L3, 23.2%; L4, 3.1%; L5, 0.8%). Furthermore, the study found that disc herniation was associated with a higher incidence of VAR not only in close neighboring vertebrae but also in distant neighboring vertebrae. This indicates that the biomechanical influence of LDH extends beyond just the immediate adjacent vertebrae. To identify potential risk factors for VAR in LDH patients, multivariate analysis was performed. The results revealed that age was an independent risk factor for VAR (OR 1.022, 95% CI [1.011, 1.034], P < 0.001). However, the duration of symptoms and presence of back pain were not found to be significant risk factors for VAR.

470 Changes in CT Hounsfield Unit and T Score Before and After Osteoporosis Treatment With Teriparatide or Denosumab

INTRODUCTION: In 2004, 10 million individuals over the age of 50 were estimated to suffer from osteoporosis in the US and this prevalence was expected to rise dramatically. Currently the standard for diagnosis is by defining the bone mineral density using a dual energy xray absorptiometry (DEXA) machine. Literature has demonstrated that the hounsfield (HU) on a CT of the lumbar spine vertebrae can be an extremely sensitive and specific metric towards identifying those with osteoporosis or osteopenia, however further evaluation of this measure and how it changes with osteoporosis treatment, specifically with newer treatment options (ie denosumab and teriparatide) is needed. METHODS: Chart review was completed for patients started on denosumab or teriparatide between 2014 and 2022. Patients were included if they were started on denosumab or teriparatide for osteoporosis or osteopenia treatment and had a DEXA and CT available at some point pre or post treatment. Demographic, medication information, pre and post treatment both DEXA based T scores and CT Hounsfield units (HU) at T12-L3 were collected. ANOVA and T tests were used for statistical analysis. RESULTS: A total of 38 patients were included in our study. Average premedication HU at T12, L1, L2, L3 were 106, 94, 92, and 83 respectively. Those treated with teriparatide showed a significant (p = 0.03) decrease in HU at L1 over the study period compared to those treated with Denosumab. CONCLUSIONS: HUs can serve as a widely available surrogate to both diagnose and monitor the treatment of osteoporosis.

Prevalence of bifidity of the seventh cervical vertebral spinous process in southwestern Nigeria: a computed tomography based study

Palpation of the seventh cervical vertebra (C7) is an important landmark for counting vertebrae for vertebral spine surgical instrumentation. However, studies have shown that the spinous process of C7 displays an anatomical deviation among individuals, which may mislead a surgeon who is not aware of this, and there have been no such studies among southwest Nigerians. The present study aimed to examine the incidence of bifidity in the C7 spinous process and their variation among 48 subjects with the aid of a three-dimensional (3D) computed tomography. The 48 subjects who had undergone cervical spine computed tomography studies comprised the pooled data of ages between 12 and 55 years of black race in southwest Nigeria from the radiology department of the Trauma and Surgical Centre, Ondo State, Nigeria. A series of multivariate and discriminant statistical tests were performed on the measurement data to determine the occurrence of bifid spinous processes at C7 in southwestern Nigeria. The results show about 10% bifidity in the C-7 vertebra and no bifidity in the first cervical vertebra and the highest rate in the C-6 vertebra in the study population. The incidence in this study is significantly higher than findings in previous works. Thus, there is a need for clinicians to pay more attention to this variation when using C7 as a landmark especially in the studied population.

A COMPARATIVE CLINICAL STUDY ON AGNIKARMA, NIRGUNDYADI UPANAHA, AND SHEPHALIKA KWATHA IN MANAGING GREEVA SANDHI-GATA VATA WITH RESPECT TO CERVICAL SPONDYLOSIS.

Greevasandhigata Vata is a form of Vata Vyadhi caused by the interference or entrance of vitiated Vata in Greeva Sandhi, leading to symptoms like Sandhishoola (pain in joint), Sandhishopa (sweeling in joint), Prasaran Aakunchnayo Pravariticha Savedana (restricted movement of joint) etc. Cervical Spondylosis is one of the leading disorders in older adults caused by degenerative changes in cervical spine vertebrae and causing symptoms like pain &amp; restricted joint movement, etc., in the neck, which further leads to the struggle of the patients to fulfil their daily routine work. Patients of Cervical spondylosis, are bound to choose analgesics, anti-inflammatory drugs, steroid injections and physiotherapy as conservative treatments to improve their quality of life. In the advanced stage, surgical treatments like spinal fusion, spinal decompression, etc., are the only options. However, these procedures do not fulfil the goal of patients because of the very high cost and therapeutic limitations. Even after surgery, patients have to take analgesics for longer duration. These drugs are also not free from adverse effects like gastritis, hyperacidity, nephrotoxicity, etc. Treatment modalities like Agnikarma, Nirgundyadi Upanaha and Shephalika Kwatha are the non-pharmacological and result oriented therapies, recommended in Ayurveda for such type of disease condition. These are proven to be Vatashamaka &amp; Vedanashamaka in various contexts.

Transient binocular vision loss and pain insensitivity in Klippel–Feil syndrome: a case report

BackgroundKlippel–Feil syndrome is a rare congenital bone disorder characterized by an abnormal fusion of two or more cervical spine vertebrae. Individuals with Klippel–Feil syndrome exhibit diverse clinical manifestations, including skeletal irregularities, visual and hearing impairments, orofacial anomalies, and anomalies in various internal organs, such as the heart, kidneys, genitourinary system, and nervous system.Case presentationThis case report describes a 12-year-old Pashtun female patient who presented with acute bilateral visual loss. The patient had Klippel–Feil syndrome, with the typical clinical triad symptoms of Klippel–Feil syndrome, along with Sprengel’s deformity. She also exhibited generalized hypoalgesia, which had previously resulted in widespread burn-related injuries. Upon examination, bilateral optic disc swelling was observed, but intracranial pressure was found to be normal. Extensive investigations yielded normal results, except for hypocalcemia and low vitamin D levels, while parathyroid function remained within the normal range. Visual acuity improved following 2 months of calcium and vitamin D supplementation, suggesting that the visual loss and optic nerve swelling were attributed to hypocalcemia. Given the normal parathyroid function, it is possible that hypocalcemia resulted from low vitamin D levels, which can occur after severe burn scarring. Furthermore, the patient received a provisional diagnosis of congenital insensitivity to pain on the basis of the detailed medical history and the findings of severe and widespread loss of the ability to perceive painful stimuli, as well as impaired temperature sensation. However, due to limitations in genetic testing, confirmation of the congenital insensitivity to pain diagnosis could not be obtained.ConclusionThis case highlights a rare presentation of transient binocular vision loss and pain insensitivity in a patient with Klippel–Feil syndrome, emphasizing the importance of considering unusual associations in symptom interpretation.

The value of TECAR in acute painful osteoporotic vertebral fractures: a pilot study.

Low-back pain is frequent, especially in the active adult population after an osteoporotic vertebral fracture. Several orthopaedic conditions can cause low back pain, significantly worsening the quality of life. The treatments vary from drugs, physical therapy, kinesiology, and local infiltration. TECARs have a crucial role in treating the inflammatory causes of pain, with several studies demonstrating the efficacy of 0.5 Mh radio frequency longwave therapy in treating low-back pain. We treat twenty consecutive patients with low back pain after a vertebral amielic spinal fracture with or without leg pain, using a combination of painkillers, orthosis, and half of them tecar therapy. The patients were treated three times a week, every other day, for 20 sessions. We evaluated clinical outcomes using the visual analogic scale for indi-vidual pain. Tests started before the beginning of therapies and eight weeks after the end of the treatment. Visual analogic scale (VAS) score significantly improved from an average value pretreatment to a 50% reduction average value eight weeks posttreatment. Patients denoted a more significant improvement in VAS and empiric patient satisfaction in the group with low back pain also treated with TECAR. Acute back pain is a relatively common clinical situation. The treatments for this condition are different, and they can give 2 a crucial role in diathermia, shortwave, microwave, and tecar therapy. This study concludes that the association between painkillers, orthosis, exercises, and tecar therapy in treating low-back Pain after an amyelic vertebral spine fracture type genant, with or without leg pain, can significantly reduce pain and improve the quality of life. ''Highlights'' Diathermy Tecar is an almost new and updated physical therapy that uses electromagnetic waves to treat muscle and joint pain through capacitive and resistive pads. It provides good pain relief for several sharp pains. The physiotherapist should be trained to use them appropriately in acute settings.

The effect of regular running on the bone tissue of middle-aged men and women.

Many authors consider running to be a protective physical activity (PA) in bone health. However, many studies also show inconsistencies in their results. The objective of the study is to analyze the effect of cumulative loading rate (TCL) on the bone mass of middle-aged runners and non-runners is assessed. This cross-sectional study included 322 individuals. There were 212 runners (109 male, 103 female) and those were individuals who did >10 km of running per week. There were 110 non-runners (54 male, 56 female). This group included individuals who did not adhere to the WHO (2020) recommendations for PA. The average age in the individual groups ranged from 40.9±4.1 to 42.3±4.8 years. Bone parameters were measured on the lower extremities and vertebral spine using the DXA method (Hologic QDR Horizon A). Multi-regression dependencies analysis was used to assess the results. The results of the multi-regression dependencies analysis showed that the bone mineral content (BMC) and bone mineral density (BMD) are significantly influenced by the TCL and gender. Therefore, we can conclude that running could be a suitable PA for preventing the reduction of BMD in the middle-aged population, especially in the lower limbs.

Сравнительный анализ влияния декомпрессионных методик на диапазон движения позвонков в грудопоясничном отделе позвоночного столба у собак

The work was carried out with the aim of conducting a comparative analysis of the effect of hemilaminectomy and mini-hemilaminectomy on the range of motion of the vertebrae in the thoracolumbar spine in dogs and to establish a correlation between changes in the range of motion of the vertebrae at the site of decompression and in adjacent spinal motion segments with the incidence of relapses of intervertebral disc extrusions and the emergence of a «domino effect». The research was carried out in 2023 on the basis of the Department of Veterinary Surgery of the Federal State Budgetary Educational Institution of Higher Education MGAVMiB – MBA named after K. I. Scriabin. The object of the study was sectioned material from dogs of chondrodystrophic breeds (n=5), the subject of the study was the thoracolumbar section of the spinal column Th10-S1. The range of motion of the vertebrae in each individual spinal motion segment was studied by comparing their positions in the neutral position, during flexion and during extension: in the native state – 3 samples, in the native state and after hemilaminectomy at the Th13-L1 level – 1 sample, in in the native state and after performing a mini-hemilaminectomy at the Th13-L1 level – 1 sample. At the site where the decompression technique was applied, the range of Th13-L1 vertebral motion increased by 51,66 % with hemilaminectomy and decreased by 0,76 % with mini-hemilaminectomy (the difference is statistically significant, p=0.001). In the adjacent spinal motion segment Th12– Th13, the range of vertebral motion increased by 22,25 % with hemilaminectomy and by 8,39 % with mini-hemilaminectomy (the difference is statistically significant, p=0,01). The correlation coefficient between the frequency of relapses of extrusions and changes in the range of motion of the vertebrae at the site of decompression is 0,71, which indicates a relationship between the average tightness between the analyzed indicators. The correlation coefficient for the risk of the «domino effect » and changes in the range of motion of the vertebrae in spinal motion segments adjacent to the site of decompression is 0,77, which indicates a strong correlation between the analyzed indicators.

Muscle Mass and Strength Gains Following Resistance Exercise Training in Older Adults 65-75Years and Older Adults Above 85Years.

Resistance exercise training (RET) can be applied effectively to increase muscle mass and function in older adults (65-75years). However, it has been speculated that older adults above 85years are less responsive to the benefits of RET. This study compares the impact of RET on muscle mass and function in healthy older adults 65-75years versus older adults above 85years. We subjected 17 healthy older adults 65-75years (OLDER 65-75, n = 13/4 [female/male]; 68 ± 2years; 26.9 ± 2.3kg/m2) and 12 healthy older adults above 85years (OLDER 85+, n = 7/5 [female/male]; 87 ± 3years; 26.0 ± 3.6kg/m2) to 12weeks of whole-body RET (three times per week). Prior to, and after 6 and 12weeks of training, quadriceps and lumbar spine vertebra 3 muscle cross-sectional area (computed tomography scan), whole-body lean mass (dual-energy X-ray absorptiometry scan), strength (one-repetition maximum test), and physical performance (timed up and go and short physical performance battery) were assessed. Twelve weeks of RET resulted in a 10% ± 4% and 11% ± 5% increase in quadriceps cross-sectional area (from 46.5 ± 10.7 to 51.1 ± 12.1cm2, and from 38.9 ± 6.1 to 43.1 ± 8.0cm2, respectively; p < .001; η2 = .67); a 2% ± 3% and 2% ± 3% increase in whole-body lean mass (p = .001; η2 = .22); and a 38% ± 20% and 46% ± 14% increase in one-repetition maximum leg extension strength (p < .001; η2 = .77) in the OLDER 65-75 and OLDER 85+ groups, respectively. No differences in the responses to RET were observed between groups (Time × Group, all p > .60; all η2 ≤ .012). Physical performance on the short physical performance battery and timed up and go improved (both p < .01; η2 ≥ .22), with no differences between groups (Time × Group, p > .015; η2 ≤ .07). Prolonged RET increases muscle mass, strength, and physical performance in the aging population, with no differences between 65-75years and 85+years older adults.

Med-Query: Steerable Parsing of 9-DoF Medical Anatomies with Query Embedding.

Automatic parsing of human anatomies at the instance-level from 3D computed tomography (CT) is a prerequisite step for many clinical applications. The presence of pathologies, broken structures or limited field-of-view (FOV) can all make anatomy parsing algorithms vulnerable. In this work, we explore how to leverage and implement the successful detection-then-segmentation paradigm for 3D medical data, and propose a steerable, robust, and efficient computing framework for detection, identification, and segmentation of anatomies in CT scans. Considering the complicated shapes, sizes, and orientations of anatomies, without loss of generality, we present a nine degrees of freedom (9-DoF) pose estimation solution in full 3D space using a novel single-stage, non-hierarchical representation. Our whole framework is executed in a steerable manner where any anatomy of interest can be directly retrieved to further boost inference efficiency. We have validated our method on three medical imaging parsing tasks: ribs, spine, and abdominal organs. For rib parsing, CT scans have been annotated at the rib instance-level for quantitative evaluation, similarly for spine vertebrae and abdominal organs. Extensive experiments on 9-DoF box detection and rib instance segmentation demonstrate the high efficiency and effectiveness of our framework (with the identification rate of 97.0% and the segmentation Dice score of 90.9%), compared favorably against several strong baselines (e.g., CenterNet, FCOS, and nnU-Net). For spine parsing and abdominal multi-organ segmentation, our method achieves competitive results on par with stateof-the-art methods on the public CTSpine1K dataset and FLARE22 competition, respectively. Our annotations, code, and models are available at: Med-Query.

Comparing image normalization techniques in an end-to-end model for automated modic changes classification from MRI images

IntroductionModic Changes (MCs) are MRI alterations in spine vertebrae's signal intensity. This study introduces an end-to-end model to automatically detect and classify MCs in lumbar MRIs. The model's two-step process involves locating intervertebral regions and then categorizing MC types (MC0, MC1, MC2) using paired T1-and T2-weighted images. This approach offers a promising solution for efficient and standardized MC assessment. Research questionThe aim is to investigate how different MRI normalization techniques affect MCs classification and how the model can be used in a clinical setting. Material and methodsA combination of Faster R–CNN and a 3D Convolutional Neural Network (CNN) is employed. The model first identifies intervertebral regions and then classifies MC types (MC0, MC1, MC2) using paired T1-and T2-weighted lumbar MRIs. Two datasets are used for model development and evaluation. ResultsThe detection model achieves high accuracy in identifying intervertebral areas, with Intersection over Union (IoU) values above 0.7, indicating strong localization alignment. Confidence scores above 0.9 demonstrate the model's accurate levels identification. In the classification task, standardization proves the best performances for MC type assessment, achieving mean sensitivities of 0.83 for MC0, 0.85 for MC1, and 0.78 for MC2, along with balanced accuracy of 0.80 and F1 score of 0.88. Discussion and conclusionThe study's end-to-end model shows promise in automating MC assessment, contributing to standardized diagnostics and treatment planning. Limitations include dataset size, class imbalance, and lack of external validation. Future research should focus on external validation, refining model generalization, and improving clinical applicability.