Anatomic Parameters for Diagnosing Congenital Lumbar Stenosis Based on Computed Tomography of 1,000 Patients.

Introduction: Quantitative parameters for diagnosis of congenital lumbar stenosis (CLS) have yet to be universally accepted. This study establishes parameters for CLS using CT, assessing the influences of patient sex, race, ethnicity, and anthropometric characteristics.

Methods: Interpedicular distance (IPD), pedicle length, canal diameter, and canal area were measured using 1,000 patients between 18 and 35 years of age who were without spinal pathology.

Morphometric analysis of cervical disc space height and interpedicular distance using computed tomography.

Background: This study utilized computed tomography (CT) to establish normative radiographic morphometric measurements of cervical disc space height (DSH) and interpedicular distance (IPD) and document the influence of patient sex, race, ethnicity, and anthropometric characteristics.

Methods: Cervical CTs of 1000 patients between 18 and 35 years of age without known spinal pathology were reviewed. Statistical analyses included the assessment of associations between patient height, weight, sex, race, and ethnicity regarding DSH and IPD.

Morphometric analysis of cervical neuroforaminal dimensions from C2-T1 using computed tomography of 1,000 patients.

Background: Race and sex differences are not consistently reported in the literature. Fundamentally, anatomical differences of cervical neuroforaminal dimensions (CNFD) amongst these groups would be important to know.

Purpose: To establish normative radiographic morphometric measurements of CNFD and uncover the influence of patient sex, race, and ethnicity while also considering anthropometric characteristics.

Oblique lateral interbody fusion at L5-S1: feasibility, surgical approach window, incision line, and influencing factors.

Purpose: The primary aim of this study was to describe the feasibility, surgical approach window (SAW), and incision line (IL) for oblique lateral interbody fusion at L5-S1 (OLIF51) using computed tomography (CT). A secondary aim was to identify associations among approach characteristics and demographic and anthropometric factors.

Methods: We performed a radiographic study of 50 male and 50 female subjects who received abdominal CT imaging.

Correlations among Cervical, Thoracic, and lumbar Hounsfield Unit measurements for assessment of bone mineral density.

Objective: Bone mineral density assessment using Hounsfield Unit (HU) currently depends upon the availability of computed tomography (CT) of the lumbar spine. The primary aim of this study was to evaluate the associations among HU measurements of the cervical (CHU), thoracic (THU), and lumbar (LHU) spine. The secondary aim of this study was to analyze the influence of patient demographic and anthropometric characteristics on HU measurements.

Anatomic Assessment of L1-S1 Neuroforaminal Dimensions Using Computed Tomography in 1,000 Patients: A Follow-Up Study.

Objectives: While the radiographic criteria for diagnosing central lumbar stenosis are well described, criteria for diagnosing neuroforaminal stenosis (NFS) are unclear. Prior research has utilized magnetic resonance imaging (MRI) to characterize neuroforaminal dimensions (NFDs). However, this approach has inherent limitations that can adversely impact measurement accuracy.

Normative Measurements of L1 to S1 Neuroforaminal Dimensions Derived From Plain Film Radiography, Computed Tomography, and Magnetic Resonance Imaging.

Study Design: Retrospective cohort.

Objective: To report normative measurements of L1 to S1 lumbar neuroforamina on plain film radiography (PFR), computed tomography (CT), and magnetic resonance imaging (MRI), accounting for patients' sex and ethnicity.

Background: The quantitative criteria fothe diagnosis of neuroforaminal stenosis remains unknown.

Comparison of L1-S1 neuroforaminal dimensions derived from plain film radiography versus computed tomography.

Purpose: To compare measurements of lumbar neuroforaminal dimensions (NFD) derived from plain film radiography (PFR) and computed tomography (CT) of young patients without spinal pathology.

Methods: We analyzed 213 patients between 18 and 35 years of age without spinal pathology who received PFR and CT within one year of each other. NFD were defined as foraminal height, sagittal anterior-to-posterior width, and area.

Comparison of Nonneurological Structures at Risk During Anterior-to-Psoas Versus Transpsoas Surgical Approaches Using Abdominal CT Imaging From L1 to S1.

Background: The kidneys, ribs, liver, spleen, and iliac crests can pose access-related issues to the disc space during both anterior-to-psoas (ATP) and transpsoas (TP) surgical approaches. The aim of this study was to identify and compare the presence and degree of obstruction caused by these structures for the ATP and TP approaches bilaterally from L1 to S1 using abdominal computed tomography.

Methods: Presence of obstruction by a given structure was recorded if the structure was within ATP or TP borders.

Anatomic Assessment of L1-S1 Neuroforaminal Dimensions Using Computed Tomography.

Background: Although the radiographic parameters for diagnosing central lumbar canal stenosis are well described, parameters for the diagnosis of neuroforaminal stenosis (NFS) are less well defined. Previous studies have used magnetic resonance imaging (MRI) and radiography to describe neuroforaminal dimensions (NFDs). Those methods, however, have limitations that may substantially distort measurements.

Anterior-To-Psoas Approach Measurements, Feasibility, Non-Neurological Structures at Risk and Influencing Factors: A Bilateral Analysis From L1-L5 Using Computed Tomography Imaging.

Background And Objectives: Spinal fusion through the anterior-to-psoas (ATP) technique harbors several approach-related risks. We used abdominal computed tomography imaging to analyze the L1-L5 ATP fusion approach measurements, feasibility, degree of obstruction by non-neurological structures, and the influence of patient characteristics on ATP approach dimensions.

Methods: The vascular window, psoas window, safe window, and incision line anterior and posterior margins for the ATP approach were measured on abdominal computed tomography imaging.

CT-based analysis of oblique lateral interbody fusion from L1 to L5: location of incision, feasibility of safe corridor approach, and influencing factors.

Purpose: The primary aim was to measure the safe corridor (SC), surgical incision anterior margin (AM), and posterior margin (PM) for OLIF bilaterally from L1 to L5. The secondary aim was to determine the feasibility of approach via the SC. The tertiary aim was to analyze the influence of demographic and anthropometric factors on OLIF parameters.

Predicting Pedicle Screw Pullout and Fatigue Performance: Comparing Lateral Dual-Energy X-Ray Absorptiometry, Anterior to Posterior Dual-Energy X-Ray Absorptiometry, and Computed Tomography Hounsfield Units.

Background: As the prevalence and associated health care costs of osteoporosis continue to rise in our aging population, there is a growing need to continue to identify methods to predict spine construct integrity accurately and cost-effectively. Dual-energy x-ray absorptiometry (DEXA) in both anterior to posterior (AP) and lateral planes, as well as computed tomography (CT) Hounsfield units (HU), have all been investigated as potential preoperative predictive tools. The purpose of this study is to determine which of the 3 bone density analysis modalities has the highest potential for predicting pedicle screw biomechanics.

Comparison of cervical, thoracic, and lumbar vertebral bone quality scores for increased utility of bone mineral density screening.

Purpose: To evaluate the associations among the validated lumbar vertebral bone quality (VBQ) score, and cervical and thoracic VBQ scores.

Methods: Radiographic records of 100 patients who underwent synchronous MRI of the cervical, thoracic, and lumbar spine were retrieved. DEXA-validated lumbar VBQ was calculated using median signal intensity (MSI) of the L1-L4 vertebrae and L3 CSF.

Intra- and inter-observer reliability of the novel vertebral bone quality score.

Purpose: To assess the intra- and inter-observer reliability of the novel vertebral bone quality (VBQ) scoring system.

Methods: Four orthopedic surgery residents at various levels of training (PGY1-4) evaluated 100 noncontrast, T1-weighted MRIs of the lumbar spine. VBQ was calculated as quotient of the median of L1-L4 average signal intensity (SI) and the L3 cerebral spinal fluid (CSF) SI, as described by Ehresman et al.

Hoffmann sign: clinical correlation of neurological imaging findings in the cervical spine and brain.

Study Design: Retrospective validity study.

Objective: To investigate the relationship between Hoffmann sign and radiographical evidence of cervical spinal cord compression and brain lesions.

Summary Of Background Data: Clinical significance of Hoffmann sign remains controversial with conflicting reports regarding its sensitivity and specificity and its usefulness.

Independent assessment of a new pedicle probe and its ability to detect pedicle breach: a cadaveric study.

Object: The authors undertook an independent, non-industry funded cadaveric study to evaluate the efficacy of a pedicle-probing device, which uses impedance measurement to warn of impending and actual pedicle screw breach.

Methods: A previously validated fresh-frozen cadaver model (saline-soaked spine) was used. Individuals at 3 levels of training (attending spine surgeon, orthopedic surgery resident, and medical student) used a cannulated pedicle-probing device to cannulate each of the levels between T-2 and S-1.

The effect of whole-body cooling on brain metabolism following perinatal hypoxic-ischemic injury.

Introduction: Magnetic resonance imaging (MRI) and spectroscopy (MRS) have proven valuable in evaluating neonatal hypoxic-ischemic injury (HII).

Results: MRI scores in the basal ganglia of HII/HT(+) neonates were significantly lower than HII/HT(-) neonates, indicating less severe injury and were associated with lower discharge encephalopathy severity scores in the HII/HT(+) group (P = 0.01).

Hypoxic-ischemic injury: utility of susceptibility-weighted imaging.

Magnetic resonance imaging is increasingly used to assess neonatal hypoxic-ischemic injury, and several scoring systems were developed to predict neurologic outcomes in these patients. We examined the magnetic resonance imaging studies of 33 neonates/infants who manifested acute perinatal hypoxic-ischemic injuries. Using a seven-point susceptibility-weighted imaging categorical grading scale, each patient received a "prominence of vein" score, which was dichotomized into a "normal" or "abnormal" group.

Advanced neuroimaging in children with nonaccidental trauma.

Physical abuse associated with nonaccidental trauma (NAT) affects approximately 144,000 children per year in the USA and, frequently, these injuries affect the developing brain. Most infants with suspected NAT are initially evaluated by skull X-rays and computed tomography to determine whether fractures are present, the severity of the acute injury and the need for urgent neurosurgical intervention. Increasingly, magnetic resonance imaging (MRI) is conducted as it provides additional diagnostic and prognostic information about the extent and nature of the injury.

Influence of common orthodontic appliances on the diagnostic quality of cranial magnetic resonance images.

Introduction: The aim of this study was to evaluate cranial magnetic resonance (MR) image distortion caused by various orthodontic brackets.

Methods: Ten subjects received 5 consecutive cranial MR scans. A control scan was conducted with Essix trays (GAC International, Bohemia, NY) fitted over the maxillary and mandibular teeth.

Hypopharyngeal cancer.

Hypopharyngeal cancers are usually squamous cell carcinomas (SCCs) that has the worst prognosis among the head and neck cancers. Overall, 5-year survival rate remains poor despite recent improvements in diagnostic imaging, radiation and chemotherapy, and improved surgical techniques. Hypopharyngeal cancers tend to present with advanced primary disease, and nodal metastasis is highly likely.

Elevated total peripheral leukocyte count may identify risk for neurological disability in asphyxiated term neonates.

Objective: The present study investigated the relationship between neurologic outcome and total circulating white blood cell (WBC) and absolute neutrophil counts (ANCs) in the first week of life in term infants with hypoxic-ischemic encephalopathy (HIE).

Study Design: Long-term neurologic outcome at 18 months was measured retrospectively in 30 term neonates with HIE using the Pediatric Cerebral Performance Category Scale (PCPCS) score with outcomes dichotomized as either good or poor. We then compared white blood cell and ANC levels during the first 4 days of life and magnetic resonance imaging (MRI) obtained within the first month life between the two PCPCS groups.

Relationship between opioid therapy, tissue-damaging procedures, and brain metabolites as measured by proton MRS in asphyxiated term neonates.

To examine the effects of opioid and tissue-damaging procedures (TDPs) [i.e. procedures performed in the neonatal intensive care unit (NICU) known to result in pain, stress, and tissue damage] on brain metabolites, we reviewed the medical records of 28 asphyxiated term neonates (eight opioid-treated, 20 non-opioid treated) who had undergone magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (MRS) within the first month of life as well as eight newborns with no clinical findings of asphyxial injury.