Assessment of Inter- and Intraobserver Reliability and Accuracy to Evaluate Apical Vertebral Rotation Using Four Methods: An Experimental Study Using a Saw Bone Model.

Study Design: After placing a thoracic three-vertebra segment saw bones model on a standardized turntable, a series of anteroposterior (AP) radiographs were obtained and then set in increments to 90° rotation. Then the specimen was instrumented with 35-mm pedicle screws bilaterally and the rotation process and image acquisition were repeated.

Objective: Assess reliability and accuracy of spine surgeons evaluating apical vertebral rotation (AVR) through surgeon's visual x-ray estimation, Nash-Moe system, Upasani trigonometric method, and Upasani grading system.

Surgeon Reliability for the Assessment of Lumbar Spinal Stenosis on MRI: The Impact of Surgeon Experience.

Background: Treating surgeon's visual assessment of axial MRI images to ascertain the degree of stenosis has a critical impact on surgical decision-making. The purpose of this study was to prospectively analyze the impact of surgeon experience on inter-observer and intra-observer reliability of assessing severity of spinal stenosis on MRIs by spine surgeons directly involved in surgical decision-making.

Methods: Seven fellowship trained spine surgeons reviewed MRI studies of 30 symptomatic patients with lumbar stenosis and graded the stenosis in the central canal, the lateral recess and the foramen at T12-L1 to L5-S1 as none, mild, moderate or severe.

Comparison of Surgeon Rating of Severity of Stenosis Using Magnetic Resonance Imaging, Dural Cross-Sectional Area, and Functional Outcome Scores.

Objective: To determine the relationship between the severity of stenosis graded using both surgeons' visual assessment of spinal stenosis as well as measurement of dural cross-sectional area on magnetic resonance imaging (MRI), with the patient's disability.

Methods: Seven fellowship-trained spine surgeons reviewed MRI studies retrospectively of 30 symptomatic consecutive patients with lumbar stenosis and graded stenosis in the central canal, the lateral recess, and the foramen at T12-L1 to L5-S1 as none, mild, moderate, or severe. Dural cross-sectional area was measured at each level from T12-L1 to L5-S1.

Distal femoral rotational axes in Indian knees.

Purpose: To measure the angular relationships of distal femoral rotational axes in 100 normal Indian knees.

Methods: 42 men and 8 women aged 26 to 40 (mean, 31) years, with 100 normal non-arthritic knees were recruited. Anatomic landmarks were measured using computed tomography.

Computerized tomographic morphometric analysis of subaxial cervical spine pedicles in young asymptomatic volunteers.

Background: Although cervical spine pedicle screws have been shown to provide excellent fixation, widespread acceptance of their use is limited because of the risk of injury to the spinal cord, nerve roots, and vertebral arteries. The risks of pedicle screw insertion in the cervical spine can be mitigated by a three-dimensional appreciation of pedicle anatomy. Normative data on three-dimensional subaxial pedicle geometry from a large, young, and asymptomatic North American population are lacking.

A comparison of coronal plane axial femoral relationships in Asian patients with varus osteoarthritic knees and healthy knees.

Standing full-length radiographs were measured to compare coronal femoral axes between 250 limbs in patients with varus osteoarthritis with 50 healthy controls. Mean distal femoral axis-mechanical axis angle was 7.3 degrees +/- 1.

Tibial torsion in non-arthritic Indian adults: a computer tomography study of 100 limbs.

Background: Knowledge of normal tibial torsion is mandatory during total knee replacement (TKR), deformity correction and fracture management of tibia. Different values of tibial torsion have been found in different races due to biological and mechanical factors. Value of normal tibial torsion in Indian limbs is not known, hence this study to determine the norm of tibial torsional value in normal Indian population.

Cruciate ligaments in arthritic knees: a histologic study with radiologic correlation.

Anterior cruciate ligaments (ACLs) and posterior cruciate ligaments (PCLs) from 45 osteoarthritic knees were histologically examined to evaluate the frequency and grade the severity of degenerative changes, which were correlated with radiologic grade of arthritis and severity of deformity at the knee. Immunohistochemical staining was used to identify neurofilaments in 10 knees. A histologic score was generated for both cruciates based on changes found on light microscopy.

Quantitative anatomy of subaxial cervical lateral mass: an analysis of safe screw lengths for Roy-Camille and magerl techniques.

Study Design: Determination of lateral mass screw lengths with Roy-Camille and Magerl techniques of screw insertion using computerized tomography in 98 young, asymptomatic North American volunteers.

Objective: To provide reliable and normative data on safe screw lengths using the Roy-Camille and Magerl techniques of lateral mass fixation in the subaxial cervical spine.

Summary Of Background Data: Lateral mass screw lengths have been studied in the past using differing subject and measurement characteristics and small sample sizes.

Degenerative cervical spondylosis: clinical syndromes, pathogenesis, and management.

Degenerative changes in the cervical spinal column are ubiquitous in the adult population, but infrequently symptomatic. The evaluation of patients with symptoms is facilitated by classifying the resulting clinical syndromes into axial neck pain, cervical radiculopathy, cervical myelopathy, or a combination of these conditions. Although most patients with axial neck pain, cervical radiculopathy, or mild cervical myelopathy respond well to initial nonsurgical treatment, those who continue to have symptoms or patients with clinically evident myelopathy are candidates for surgical intervention.

Tibial articular cartilage wear in varus osteoarthritic knees: correlation with anterior cruciate ligament integrity and severity of deformity.

Tibial articular cartilage wear was assessed intraoperatively in 100 consecutive patients with varus osteoarthritis undergoing total knee arthroplasty. Severity of deformity on radiographs, integrity of the anterior cruciate ligament (ACL) at surgery, and body mass index were recorded. Posterior half of the medial tibial plateau was more commonly involved in knees with ACL deficiency; there was predominantly anteromedial involvement with an intact ACL.

Primary total hip arthroplasty in protrusio acetabuli using impacted morsellized bone grafting and cementless cups: a medium-term radiographic review.

Thirty primary total hip arthroplasties were performed for protrusio acetabuli in 23 patients (mean age, 46 years) using impacted autologous bone grafting and a cementless porous-coated hemispheric cup without the use of metal cages or rings. At 2 to 10 years' follow-up (mean, 4.2 years), there was satisfactory radiographic evidence of consolidation of the graft in all cases.