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Spinous Processes (spinous + process)
Selected AbstractsScapular development from the neonatal period to skeletal maturity: A preliminary studyINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 5 2007C. Rissech Abstract An understanding of the basic growth rates and patterns of development for each element of the human skeleton is important for a thorough understanding and interpretation of data in all areas of skeletal research. Yet surprisingly little is known about the detailed ontogenetic development of many bones, including the scapula. With the intention of describing the changes that accompany postnatal ontogeny in the scapula and algorithms to predict sub-adult age at death, this communication examines the development of the scapula through nine measurements (3 from the glenoidal area, 4 from the body and 2 related to the spinous process) by polynomial regression. Data were collected from 31 of the individuals that comprise the Scheuer Collection, which is housed at the University of Dundee (Scotland). Four of the derived mathematical curves (scapular length, infra- and suprascapular height and spine length) displayed linear growth, whilst three (maximum length of the glenoid mass, acromial width and scapular width) were best expressed by a second-degree polynomial and two (maximum and middle diameter of the glenoidal surface) by a third-degree polynomial. All single measurements proved useful in the prediction of age at death, although derived indices proved to be of limited value. In particular, scapular width, suprascapular height and acromial width showed reliable levels of age prediction until late adolescent years. Copyright © 2007 John Wiley & Sons, Ltd. [source] Influence of standardized mobilization on the posteroanterior stiffness of the lumbar spine in asymptomatic subjectsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2001Dr Garry Allison Abstract Background and Purpose Spinal mobilization is commonly used to relieve pain and assist recovery of mobility in individuals with low back pain. Fundamental to this concept is the belief that spinal mobilization will influence the mechanical properties of the symptomatic motion segment. The objective of the present study was to examine the segmental effects of a standardized mobilization procedure on the posteroanterior (PA) stiffness of the lumbar spine. Method Audio and visual feedback was used to train a physiotherapist to perform PA mobilization at a consistent load and frequency. After training, twenty-four subjects without low back pain were recruited for the intervention phase of the study. The spinal posteroanterior mobilization (SPAM) apparatus was used to measure the PA stiffness of the lumbar spine at three measurement sites (L1, L3 and L5). The trained physiotherapist then applied the standardized PA mobilization technique via the L3 spinous process for two minutes. Following mobilization, PA stiffness was measured three times at the three locations. Results The physiotherapist was able to apply a standardized mobilization with a mean force of 146 N (standard deviation (SD) 8 N) at a frequency of 1.5 Hz. The first trial on each assessment demonstrated a pre-condition effect. Two minutes' PA mobilization resulted in no significant change in the PA stiffness of the lumbar spine at the level to which the mobilization was applied, or at the L1 and L5 segments. The 95% confidence intervals (CI) of the difference in PA stiffness before and after testing included zero at each measurement site. Conclusions Clinicians should pre-condition the spine when assessing PA stiffness both before and after interventions. A standardized mobilization of 150 N at 1.5 Hz for two minutes had no segmental effect on spinal PA stiffness. Subsequent studies need to consider other mechanisms that may contribute to the changes that occur after PA spinal mobilization. Copyright © 2001 Whurr Publishers Ltd. [source] Comparing the anatomical consistency of the posterior superior iliac spine to the iliac crest as reference landmarks for the lumbopelvic spine: A retrospective radiological studyCLINICAL ANATOMY, Issue 7 2007J.M. McGaugh Abstract A palpation reference line coursing between the superior-most aspect of the iliac crests has been reported to cross the L4 spinous process or L4/L5 intervertebral space in ,80% of the population. Comparable data have not been defined for the line coursing between the posterior superior iliac spines (PSIS). The purpose of this study was to compare the anatomical consistency of the PSIS to the iliac crest as landmarks used for spinal palpation. One hundred computerized tomographic images were reviewed in a three-dimensional setting. Two horizontal lines were constructed on each image: Line 1 representing the superior-most aspect of the iliac crest and Line 2 representing the inferior margin of the PSIS. The vertical distance between each horizontal line and the inferior edge of its respective spinous process were measured. The PSIS corresponded to the S2 spinous process in 81% of subjects and the iliac crest to the L4 spinous process in 59% of subjects. Distance measures suggest that the PSIS was closer to S2 versus the iliac crest to L4 (t = 6.998; P < 0.01). The PSIS crossed S2 more frequently than the iliac crest crossed L4 (,2 = 12.719, P , 0.01). The study findings support the relationship between the PSIS, and the spinous process of S2 is more consistent when compared to the iliac crest and the spinous process of L4. The PSIS reference line may be used to find S2 as a reference standard in validity and reliability palpation studies in the lower lumbar spine. Clin. Anat. 20:819,825, 2007. © 2007 Wiley-Liss, Inc. [source] A high status burial from Ripon Cathedral, North Yorkshire, England: differential diagnosis of a chest deformityINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 6 2003S. Groves Abstract Excavations beneath the crossing at Ripon Cathedral in North Yorkshire recently revealed a burial radiocarbon dated to the late 15th century AD. The burial was that of a young adult female; the location of the grave suggests a person of relatively high status. The very well preserved skeleton revealed abnormal changes to the bones of the thoracic cavity including anterior bowing of the sternum, flattening of the spinous processes of thoracic vertebrae three to nine against the processes below each one, and changes to the ribs that suggested anterior displacement of the rib cage. The skeletal changes are described and differential diagnoses presented. Treatment to an underlying chest deformity, ,pectus carinatum', is thought to be the underlying cause of the skeletal changes; this study may lend direct insight into the concepts of body image in the Medieval period. Copyright © 2003 John Wiley & Sons, Ltd. [source] Physical Medicine and Rehabilitation (87)PAIN PRACTICE, Issue 1 2001A.J. Haig Paraspinal electromyography in high lumbar and thoracic lesions. (University of Michigan, Ann Arbor, MI) Am J Phys Med Rehabil 2000;79:336,342. This study aimed to use needle electromyography in the paraspinal muscles to localize the root level of a radiculopathy. Nine cases of clinically proven, isolated high lumbar or thoracic disk herniations of patients who underwent MiniPM were collected. Four were from a prospective study of 114 persons with low back pain (MiniPM had 100% sensitivity to magnetic resonance imaging-documented high disks). In the most medial "S" column, mean MiniPM scores were 0.7 for the level above the radiologically documented lesion (3.1 at the lesion and 1.6, 1.6, and 1.1 at the 3 spinous processes below the lesion). Similar numbers were obtained in the "M" column (slightly lateral), with no significant differences between S and M. Differences were significant between and at the level of the lesion for S (P < 0.06) and M (P < 0.01), and between the lesion level and 3 levels below for the M column (P < 0.01). Conclude that paraspinal electromyography has a higher than previously reported sensitivity for high lumbar lesions. Electromyography using MiniPM can localize some radiculopathies. The individual cases suggest that, consistent with the anatomy of the caudi equina, thoracic lesions and lateral lumbar lesions denervate only at 1 level, but more central lumbar lesions also denervate distally innervated paraspinal muscles. Comment by Miles Day, MD. This study is designed to assess the sensitivity of many MiniPM for higher-level rediculopathies, ie, lower thoracic and high lumbar, and to determine if findings are specific to the root level involved. The MiniPM is thought to assess the multifidus portion of the paraspinal muscles that are innervated from L2 to the sacrum. The clinical protocol tests the paraspinal extensively and provides a numerica score, thus eliminating some subjectivity of the EMG. The study demonstrates that MiniPM has good sensitivity for high lumbar and thoracic lesions and provides information on the level of the lesion independent of limb EMG. After reviewing the study, I agree with the authors that MiniPM is in itself not diagnostic for radiculopathy, but is only an additional test to help support other neuro physiological studies when evaluating for radiculopathy. It is not specific for diagnosing radiculopathy. [source] A pilot study of patient-led identification of the midline of the lumbar spineANAESTHESIA, Issue 4 2002J. S. Wills Summary The midline of the lumbar spine is usually identified by palpation of the spinous processes. Placement of an epidural or spinal needle is more difficult when these bony landmarks are impalpable. This pilot study investigated the ability of 50 healthy volunteers to identify the midline of their own backs, using light touch or proprioception. The midline as identified in this manner was compared with the ,gold standard' as defined by the interspinous line. Sensation to light touch was the most accurate, with 90% of the volunteers able to identify the midline to within 6.5 mm. Proprioception using a finger to touch the midline was less accurate. This study was carried out on volunteers with palpable spinous processes but suggests that, in certain circumstances, a patient-led identification of the midline may be of value. [source] Model for Ultrasound-Assisted Lumbar Puncture TrainingACADEMIC EMERGENCY MEDICINE, Issue 2009Melissa Bollinger Lumbar puncture is an important diagnostic procedure in emergency medicine. Data have been published showing improved success rate with ultrasound assistance and the ability of emergency medicine physicians to recognize sonographic lumbar spinous anatomy. However, with educational models and the push for improved patient safety, procedural skills should be practiced on phantoms rather than the "see one, do one, teach one" of the past. There are no currently available phantoms for ultrasound-assisted lumbar puncture training. We have produced a phantom that can be used to train physicians on ultrasound-assisted lumbar puncture with respect to both imaging and procedural competency. A plastic fluid-filled bladder was immersed in gelled opacified mineral oil, a safe and easily used tissue mimic that obscures direct visualization of structures. Spinous anatomy is replicated with the use of wooden struts supporting wooden disks that mimic lumbar spinous processes. The spine analog was mounted over the plastic bladder and surrounded with gelled mineral oil. The phantom produces images similar to human lumbar anatomy. The phantom allows insertion of spinal needles into the "interspinous spaces" with inability to pass the needle outside of those locations. Fluid collection and repeated punctures can be performed on the phantom. Appearance and performance of the phantom were evaluated by physicians with expertise in ultrasound-assisted lumbar puncture. The only limitation is that external appearance is not realistic. This model performs well, is made from readily available materials, and can be used to train physicians in ultrasound-assisted lumbar puncture. [source] Thoracic paravertebral spread using two different ultrasound-guided intercostal injection techniques in human cadaversCLINICAL ANATOMY, Issue 7 2010Tilemachos Paraskeuopoulos Abstract The continuity between the intercostal and paravertebral space has been established by several studies. In this study, the paravertebral spread of a colored dye was attempted with two different ultrasound-guided techniques. The posterior area of the trunk was scanned with a linear probe between the level of the fifth and the seventh thoracic vertebrae in eleven embalmed human cadavers. In the first technique, the probe was placed transversely below the inferior margin of the rib, and a needle was inserted between the internal intercostal membrane and the pleura. In the second technique, the probe was placed longitudinally at the intercostal space 5 cm lateral to the spinous processes, and the needle was inserted between the internal intercostal membrane and the pleura. In both techniques, 1 ml of methylene blue was injected, and both the intercostal and paravertebral spaces were prepared. In total, 33 injections were performed: 19 with the transverse technique and 14 with the longitudinal technique. Successful spread of the dye to the thoracic paravertebral space was recorded in 89.5% cases using the transverse technique and 92.8% cases using the longitudinal technique. No intrapleural spread of the dye was recorded in either technique. Ultrasound-guided injection into the intercostal space may offer an alternative approach to the thoracic paravertebral space. Clin. Anat. 23:840,847, 2010. © 2010 Wiley-Liss, Inc. [source] | ||||||||||