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At least 307 records · Page 17Linked to original sources
PubMed2002

Comparison of bone marrow cells harvested from various bones of cynomolgus monkeys at various ages by perfusion or aspiration methods: a preclinical study for human BMT.

Using cynomolgus monkeys, we have previously established a new method for harvesting bone marrow cells (BMCs) with minimal contamination of the BMCs with T cells from the peripheral blood. We originally conducted this new "perfusion method" in the long bones (the humerus, femur, and tibia) of cynomolgus monkeys. Here, we apply the perfusion method to obtain BMCs from the ilium of cynomolgus monkeys, since BMCs are usually collected from the ilium by the conventional aspiration method in humans. The perfusion method consists of two approaches: transverse iliac perfusion and longitudinal iliac perfusion. BMCs harvested by the perfusion method from the long bones and ilium were compared with those collected from the ilium by the aspiration method. The contamination of BMCs with peripheral blood, determined by the frequencies of CD4+ and CD8+ T cells, was significantly lower in BMCs obtained from the ilium or long bones by the perfusion method (CD4+ plus CD8+ T cells <4%) than in those obtained by the iliac aspiration method (CD4+ plus CD8+ T cells >20%). However, the numbers of immature myeloid cells, such as myeloblasts, promyelocytes, myelocytes, and metamyelocytes, were higher in BMCs obtained by the iliac perfusion method than in those obtained by the iliac aspiration method. The assays for in vitro colony-forming unit in culture revealed that progenitor activity was significantly higher in BMCs obtained by the perfusion method than in those obtained by the aspiration method. These findings suggest that the contamination of BMCs with peripheral blood is much less when using the perfusion method than when using the aspiration method. To determine the best site for harvesting BMCs by the perfusion method, age-dependent changes in BMCs harvested by the perfusion method from the long bones and ilium were examined. The numbers of BMCs varied in the long bones (humerus > femur > tibia) and showed age-dependent decreases, whereas they remained similar in the ilium of cynomolgus monkeys from 3 years to 6 years of age. However, in cynomolgus monkeys, BMC harvesting by the perfusion method from the ilium (but not from the long bones) is found to involve the risk of fat emboli, particularly when the BMCs are quickly perfused under high pressure. These findings suggest, even in humans, that the perfusion method is better than the aspiration method, and that the best site for collection of BMCs is the humerus.

Aging↗
PubMed2003

Dynamic changes in the contact area of the sacroiliac joint.

Thirty adult dry-bone ilium specimens were used in conjunction with computer analysis to determine the average articular contact area between the sacrum and ilium at the sacroiliac joint. Simulating an unstable pelvic injury, the sacroiliac joint was displaced in three directions by moving the ilium posteriorly, superiorly, and posterosuperiorly. After each displacement, the contact area between the sacrum and ilium at the sacroiliac joint was calculated. The data showed that the average articular surface area of the male sacroiliac joint (1138.3 mm2) was approximately 12.8% greater than the average surface area of the female sacroiliac joint (992.5 mm2). The average articular contact area between the sacrum and ilium at the sacroiliac joint was lowest with the ilium displaced posterosuperiorly compared to equal displacements superiorly or posteriorly. This study quantitatively illustrated the loss of contact surface area between the sacrum and ilium during various displacements of the ilium, thus indicating the clinical cross-section area available for open reduction and internal fixation or fusion.

Adult↗
PubMed1991

Comparative anatomic study of anterior and posterior iliac crests as donor sites.

Ten fixed human cadaver iliums from elderly persons were studied to compare the amounts of graft material present in the anterior and posterior ilium. Average intracortical volume of surgically accessible marrow space was 15.75 mL for the anterior and 39.24 mL for the posterior ilium. Comparison of marrow volume underlying equal surface areas revealed values of 8.4 mL for the anterior and 14.8 mL for the posterior ilium. The average total volume of compressed cancellous bone obtained was 12.87 mL for the anterior and 30.31 mL for the posterior ilium. The ratio of cortical bone window surface area to resultant immediately accessible graft material was 1:0.49 for the anterior and 1:0.75 for the posterior ilium. These results confirm the greater availability of cancellous bone in the posterior ilium.

Aged↗
PubMed1996

Anatomic considerations for posterior iliac bone harvesting.

STUDY DESIGN: This study analyzed bony features of the posterior ilium and relevant vital structures using cadavers and dry ilium specimens. OBJECTIVES: To determine quantitatively the safely zone of the posterior ilium and relevant vital structures with regard to bone graft harvesting. SUMMARY OF BACKGROUND DATA: The most frequently used site for bone graft harvesting is the posterior ilium. However, complications related to posterior iliac bone harvesting, such as donor site pain, neurovascular injury, instability of the sacroiliac joint, and herniation of abdominal contents, are still major concerns. Very little research with regard to the quantitative study of the posterior ilium has been reported. METHODS: Six cadavers (four male, two female) were used for the first part of this study. The posterior superior iliac spine was determined as a reference landmark. The distances from the posterior superior iliac spine to the superior cluneal nerves, the gluteal line, and the superior gluteal vessels were measured. The second part of the study involved 30 adult, dry iliac bony specimens. The posterior iliac region (extra-articular portion) was divided into three zones, and the corresponding dimensions of these zones were measured. RESULTS: The average distances from the posterior superior iliac spine to the superior cluneal nerves, gluteal line, and superior gluteal vessels were 68.8, 26.6, and 62.4 mm, respectively. The average width, height, and maximum thickness for Zone 1 were 34, 27.8, and 17.1 mm, respectively; the measurements for Zone 2 were 16.5, 31.8, and 14.2 mm, respectively. The average height for Zone 3 was 20.4 mm, and the average maximum thickness was 16.8mm. CONCLUSION: The ideal area of the posterior ilium for bone graft harvesting was found in Zone 1. Zones 2 or 3 may be considered it a greater quantity of cancellous bone graft is required; however, the risk of injury to the sacroiliac joint and superior gluteal vessels in these zones is increased.

Aged↗
PubMed1997

Morphologic considerations of the first sacral pedicle for iliosacral screw placement.

STUDY DESIGN: Morphometric, radiographic, and computed tomographic evaluation of the pedicle of the first sacral vertebra was performed, and the pedicle's spatial relation with the posterior surface of the ilium was defined. OBJECTIVES: To facilitate accurate localization of the entry site of the iliosacral pedicular screw on the posterior surface of the ilium, to provide optimal length and direction of iliosacral screw placement, and to investigate the feasibility of inserting two screws through the first sacral vertebral pedicle for unstable posterior pelvic fixation. METHODS: Anterior and posterior pedicular height, pedicular depth, alar depth, and posterior alar height of S1 vertebrae were measured in 11 body pelves bilaterally. Sacral pedicular height was also measured on the outlet view radiograph as visualized during intraoperative fluoroscopy, and compared with actual anatomic pedicular height. The distance from the posterior limit of the ilium to the S1 ala, pedicle, and pedicle axis, and the distance between the outer table of the ilium and anterior cortex of the sacrum were measured on axial computed tomography scans. Finally, parasagittal sections of the sacral were made to assess the safety zone for placement of two pedicular screws into the vertebral body. RESULTS: The mean anterior and posterior pedicular heights were 30.2 and 26.1 mm, respectively. The depths of the pedicle and ala were 27.8 and 45.8 mm, respectively. The mean posterior alar height was 28.7 mm. The mean first sacral pedicular height measured on the outlet-view radiographs was 20 mm, which was significantly less (P < 0.0001) than the actual gross anatomic pedicular height. The mean distance from the posterior limit of the ilium to the pedicle axis projection point on axial computed tomography scans was 32.5 mm, and the mean distance from this point to the greater sciatic notch was 38.6 mm. The mean distance between the outer table of the ilium and the anterior cortex of the sacrum was 105.2 mm. The safety margin for two closely inserted pedicular screws was only 4 to 6 mm. CONCLUSIONS: This study suggests that placement of one screw through the S1 pedicle into the vertebral body is safer, and routine placement of two sacral pedicular screws may be difficult. The optimal starting point for placement of single iliosacral screw is 3 to 3.5 cm anterior to the posterior border of the iliac bone in the sagittal plans, and 3.5 to 4 cm cephalad to the greater sciatic notch. The screw should be directed perpendicular to the outer surface of the table from this entry point. The safe length of the iliosacral pedicular screw is up to 80 mm.

Adult↗
PubMed2005

Bone remodeling at the iliac crest can predict the changes in remodeling dynamics, microdamage accumulation, and mechanical properties in the lumbar vertebrae of dogs.

We previously demonstrated that suppression of bone remodeling allows microdamage to accumulate, thereby leading to reduced bone toughness in dog bone. In this study we evaluated the relationships between bone remodeling at the iliac crest and skeletal activation frequency, microdamage accumulation, or biomechanical properties of lumbar vertebrae using the same dogs to determine whether bone remodeling at the iliac crest can predict damage accumulation and mechanical parameters of the lumbar spine following treatment with antiresorptive agents. Thirty-six female beagles, 1 to 2 years old, were divided into three groups. The control group was treated daily for 12 months with saline vehicle. The remaining two groups were treated daily with oral risedronate at a dose of 0.5 mg/kg/day, or alendronate at 1.0 mg/kg/day orally. The doses of these bisphosphonates were 5 to 6 times the clinical doses approved for treatment of osteoporosis in humans. After sacrifice, the right ilium and L2 vertebra were assigned to histomorphometry. The left ilium and L3 vertebra were used for microdamage analysis. The L4 vertebra was mechanically tested to failure in compression, and bone toughness calculated from the stress-strain curve. There was a strong positive relationship for activation frequency (Ac.f) between ilium and lumbar vertebrae (r2 = 0.82; P < 0.0001). Iliac crest Ac.f underestimates Ac.f in L2, but L2 Ac.f reaches a minimum threshold and does not decline further when iliac crest Ac.f is below 0.10/yr. Microdamage (Cr.S.Dn) accumulation at the ilium was significantly associated with increased microdamage accumulation in the L3 lumbar vertebra (r2 = 0.43, P < 0.0001). The data also show that bisphosphonate treatment increased Cr.S.Dn at a faster rate in L3 than in the iliac crest. Although bisphosphonate treatment decreased bone toughness in L4, this decrease demonstrated no relationship to decreased Ac.f in the ilium. These results clearly indicate that bone remodeling data obtained from iliac crest biopsy could be used to estimate the activation frequency and microdamage burden in the vertebral column.

Administration, Oral↗
PubMed1996

Biomechanical analysis of hemipelvic deformation after corticospongious bone graft harvest from the posterior iliac crest.

STUDY DESIGN: The stiffness of the hemipelvis during simulated physiologic loading and the bone deformation in the remaining posterior ilium after the harvest of increasing sizes of corticospongious bone graft were compared with values in intact bone. OBJECTIVES: To quantify the biomechanical effects of the removal of bone grafts from the posterior ilium and to relate the size of graft removed to the stiffness of the hemipelvis and deformation of the remaining bone. SUMMARY OF BACKGROUND DATA: Bone fractures and pelvic instability have been reported to complicate graft harvest from the posterior iliac crest. There is no quantitative data relating graft size to the mechanical properties of the remaining ilium. METHODS: Seven cadaveric hemipelves were loaded with a materials testing machine through the superior sacrum while supported at the acetabulum and stabilized with a cable fixed to the ilium. Force and displacement histories and deformation in the greater sciatic notch were recorded for the intact bone and after removal of corticospongious bone graft in 1.5-cm increments from the posterior iliac crest. RESULTS: If the length of the removed corticospongious bone graft exceeded 3.0 cm, the stiffness of the posterior pelvic ring decreased, and deformation in the remaining bone increased substantially. CONCLUSIONS: Removal or bone graft in excess of 3 cm from the posterior ilium increases the risk of iatrogenic fatigue fracture.

Bone Transplantation↗
PubMed2001

S1 screw bending moment with posterior spinal instrumentation across the lumbosacral junction after unilateral iliac crest harvest.

STUDY DESIGN: A biomechanical study comparing fixation across the lumbosacral junction. OBJECTIVES: To determine which long posterior construct across the lumbosacral junction produces the least bending moment on the S1 screw when only one ilium is available for fixation. SUMMARY OF BACKGROUND DATA: Recent in vitro studies have demonstrated the benefit of anterior support and fixation into the ilium when instrumenting a long posterior construct across the lumbosacral junction. METHODS: Four L2-sacrum constructs were tested on six synthetic models of the lumbar spine and pelvis simulating that the right ilium had been harvested. Construct 1: L2-S1 bilateral screws. Construct 2: L2-S1 + left iliac bolt. Construct 3: L2-S1 + left iliac bolt + right S2 screw. Construct 4: L2-S1 + bilateral S2 screws. The four constructs were then retested with an anterior L5-S1 strut. A flexion-extension moment was applied across each construct, and the moment at the left and right S1 pedicle screw was measured with internal strain gauges. RESULTS: Iliac bolt fixation was found to significantly decrease the flexion-extension moment on the ipsilateral S1 screw by 70% and the contralateral screw by 26%. An anterior L5-S1 strut significantly decreased the S1 screw flexion-extension moment by 33%. Anterior support at L5-S1 provided no statistical decrease in the flexion-extension moment when bilateral posterior fixation beyond S1 was present with either a unilateral iliac bolt and contralateral S2 screw, or bilateral S2 screws. CONCLUSIONS: There is a significant decrease in the flexion-extension moment on the S1 screw when extending long posterior constructs to either the ilium or S2 sacral screw. There is no biomechanical advantage of the iliac bolt over the S2 screw in decreasing the moment on the S1 screw in flexion and extension. Adding anterior support to long posterior constructs significantly decreases the moment on the S1 screw. Adding distal posterior fixation to either the ilium or S2 decreases the moment on S1 screws more than adding anterior support. Further, adding anterior support when bilateral distal fixation past S1 is already present does not significantly decrease the moment on the S1 screws in flexion and extension.

Bone Screws↗
PubMed2001

[Human dynamic response to landing impact in selected body orientations].

Objective. To study changes of human dynamic response to landing impact in selected body orientations. Method. Five healthy young men were exposed to 10 G, 50 ms half-sine acceleration pulses. The angle included between human head-ilium axis and impact force direction was 30 degrees-70 degrees. The acceleration responses at head, shoulder, chest and ilium of the subjects were recorded along head-ilium and chest-back directions. Result. Within limits of the experiments, the minimum peak response at the head along head-ilium direction was 10.36 +/- 2.44 G at 50 degrees, and the maximum was 18.07 +/- 3.29 G at 70 degrees. The minimum peak response at the chest along head-ilium direction was 10.39 +/- 3.97 G at 70 degrees, and the maximum was 15.42 +/- 3.61 G at 60 degrees. The minimum peak response at the head along chest-back direction was 7.58 +/- 1.18 G at 30 degrees, and the maximum was 18.89 +/- 1.85 G at 70 degrees. The minimum peak response at the chest along chest-back direction was 7.21 +/- 1.99 G at 30 degrees, and the maximum was 17.67 +/- 2.16 G at 70 degrees. Conclusion. It was inferred that the best body orientation angle for landing impact might be 50 degrees.

Acceleration↗
PubMed2002

[A morphologic evaluation of the sacroiliac joint and plate fixation on a pelvic model using a S1 pedicular screw, transiliosacral screws, and a compression rod for sacroiliac joint injuries].

OBJECTIVES: Morphological measurements were performed, of the articular surfaces and adjacent bone structures of the sacroiliac joint on dry bone specimens to determine the projection of the sacroiliac joint on the outer table of the posterior ilium. In addition, the effect of plate fixation using transiliosacral screws and a pedicular screw on S1 attached via a compression rod was evaluated on pelvic models to be applied in sacroiliac joint injuries. METHODS: Quantitative caliper measurements of dry bone specimens including 20 os coxae and 10 sacrum were made on the articular surfaces of the sacrum and the posterior ilium, thickness of the posterior iliac bone at different levels, and the distance from the outer walls of S1 and S2 foramina to the sacral facies articularis. After the construction of a plate matching the projection of the lateral sacral mass on the outer table of the posterior ilium, four transiliosacral screws were applied lateral to the sacral foramina on pelvic models. A pedicular screw sent to S1 was attached to the plate with a threaded compression rod. RESULTS: The mean values for the articular surface of (i) the posterior ilium were 53.3 mm (base length), 38.5 mm (height), and 56.2 mm (the distance from the anterior margin of the articular surface to the spina iliaca posterior superior); and (ii) the sacrum, 57.2 mm (base length), and 34.6 mm (height). The mean thickness of the posterior ilium was 19.2 mm, and the mean distance from the lateral walls of the sacral foramina at S1 and S2 levels to the articular surface was 21.7 mm. For the deduced projection, the perpendicular line from the middle of the base was found to be the safe zone for screw applications. CONCLUSION: Through a plate applied matching the projection area, multiple screws may be sent lateral to S1 and S2 foraminal levels without damage to the sacral neural and surrounding vital structures. A stable fixation can be achieved by combining the plate/screw system with a S1 pedicular screw.

Bone Plates↗
PubMed1995

Anatomic considerations for dorsal sacral plate-screw fixation.

Five cadaveric pelves and 40 dry bony specimens were used to assess the feasibility of the lumbosacral plate fixation extending to beyond the S1 region and quantitatively to evaluate the posterior sacroiliac region and the dimensions of S1 and S2 pedicle and lateral mass. Partial removal of the posterior ilium was undertaken to measure the surface area available for plate fixation on the dorsal aspect of the sacrum. The results showed that the average distances between the outer edges of S1 and S2 dorsal foramina and the medial edge of the posterior ilium increased from 11.3 mm before removal of a portion of the medial posterior ilium to 16.6 mm after removal at the S1 level, and from 8.4 mm before removal of partial medial posterior ilium to 13 mm after removal at the S2 level, respectively. The average depths of the S1 and S2 pedicles were 37.1 and 32.2 mm in the direction anteromedial to the sagittal plane, respectively. The average depths of the S1 and S2 lateral mass were 37.3 and 33.9 mm in the direction anterolateral to the sagittal plane, respectively. In cases of vertebral metastases or osteoporosis, plating extending to S2 may be needed if good bony purchase cannot be achieved by the S1 pedicle or lateral mass screw. This study suggested also that partial removal of the posterior ilium enhances the space on the posterior aspect of the sacrum without severe compromise of the sacroiliac joint.

Aged↗
PubMed2005

Iliac hyperdense line: a new radiographic sign of gluteal muscle contracture.

BACKGROUND: A hyperdense line on the ilium that runs roughly parallel to the sacroiliac joint (we called it "iliac hyperdense line sign") was frequently observed on pelvic radiographs of patients with gluteal muscle contracture (GMC). A literature search revealed no description of this sign. OBJECTIVE: To determine the relationship between the iliac hyperdense line sign and GMC and to explore how this sign is formed. MATERIALS AND METHODS: Pelvic plain films of 103 cases of GMC and those of 200 control individuals were reviewed for the presence or absence of the iliac hyperdense line sign. Pelvic CT scans in 8 of 103 cases and 13 of 200 controls were analyzed with relation to the plain films. RESULTS: The iliac hyperdense line sign was visualized in 85 of 103 (82.5%) cases of GMC and none of the 200 controls. In the GMC group, pelvic CT scans showed a deformity of the posterior ilium. The lateral cortex of the posterior ilium took on a partly or completely anteroposterior course, while in the control group the course appeared as an oblique orientation from posteromedial to anterolateral. CONCLUSION: The iliac hyperdense line on pelvic plain film can be used as a radiographic sign to suggest a diagnosis of GMC. This sign might be a result of the long and persistent pulling effect of the contracted gluteus maximus muscle, which deforms the lateral cortex of the posterior ilium from an oblique course to an anteroposterior course tangential to the X-ray beam.

Adolescent↗
PubMed1994

Enhancement of bone ingrowth into a porous hydroxylapatite-matrix using a resorbable polylactic membrane: an experimental pilot study.

The objective of this pilot study was to study bone ingrowth into porous hydroxylapatite (HA) blocks using a polylactic membrane for guided tissue regeneration. Porous HA blocks were placed on both sides of the mandible and of the ilium in five Göttingen minipigs. On one side a polylactic membrane was used to cover the blocks. After 5 months, the blocks with the membrane covering showed complete bony penetration of the HA matrix both in the mandible and the ilium. The blocks without the membrane covering showed substantially less and irregular bone ingrowth after placement on the mandible and poor ingrowth after placement on the ilium. The newly formed bone in the blocks from the ilium showed a cancellous structure while bone tissue inside the blocks from the mandible exhibited a dense cortical appearance. The polylactic membrane was nearly completely degraded at the time of investigation.

Animals↗
PubMed1997

Pamidronate content and turnover in sternum, vertebral body, and iliac bones of dogs.

Therapeutic efficacy of bisphosphonates depends on how much drug is present in bone. Therefore, it is important to measure the amount of bone bisphosphonate in toxicological and pharmacological studies. We analyzed pamidronate content of bone samples from two previously published long-term dose studies. In the first study, mature beagle dogs were given oral pamidronate at doses of 0, 2.5, 12.5 and 25 mg/kg per day for 1 year. The dogs in the second study received the same dosages for 1 year followed by 1 year without drug. In both studies, the amount of pamidronate measured was dependent upon dose in bone samples of ilium, sternum, and vertebral body. After 1 year of treatment, vertebral bone had more pamidronate than sternum or iliac bone on a permilligram basis. After 2 years, there was significantly less pamidronate in the vertebral body, sternum, and ilium than there had been at 1 year. The fall in pamidronate content was largest in vertebral body and least in the ilium. The higher uptake of pamidronate by the vertebral body during the 1 year study, and its greater loss of pamidronate after a year without drug treatment, would reflect the higher turnover of trabecular bone in the vertebral body vs. cortical bone in the ilium. The percent difference in bone pamidronate content between the 1 and 2 year dogs varied with dose. The largest percent loss occurred in the intermediate-dose group. These data suggest that, after 1 year without the drug, bone turnover rates in dogs treated with the highest dose of pamidronate were lower than at the intermediate dose. Thus, the time required for bone turnover rates to return to pretreatment levels is probably dose-dependent.

Animals↗
PubMed1996

Anatomic considerations for posterior approach to the sacroiliac joint.

STUDY DESIGN: This anatomic study describes a new intraosseous, posterior approach to the sacroiliac joint. OBJECTIVES: To define a transosseous approach to the sacroiliac joint in which a triangular bony window is raised on the posterosuperior aspect of the ilium that provides improved access to the sacroiliac joint for posterior fusion. SUMMARY OF BACKGROUND DATA: A posterior approach to the sacroiliac joint has been widely used for debridement of infectious diseases and for fusion. Most conventional approaches to the sacroiliac joint are interosseous, and there is a relative lack of information on transiliac approaches. METHODS: The projection of the sacroiliac joint on the outer table of the ilium and the thickness of the posterior ilium forming part of the sacroiliac joint were determined in 15 cadaveric pelves. A right angle, triangular bony window was raised from the posterior ilium to investigate the suitability of a transiliac approach in performing sacroiliac debridement and arthrodesis. A horizontal reference line 3-3.5 cm in length was drawn between a point 1 cm anterosuperior to the posteroinferior iliac spine and a point 1.5 cm superior to the superior border of the greater sciatic notch. A vertical reference line was extended superiorly for 2-2.5 cm perpendicular to and beginning at the anterior end of the horizontal reference line. The oblique arm of the right triangle was created by joining the superior end of the vertical reference line to the posterior end of the horizontal line. RESULTS: Thirty percent to fifty percent of the articular surface of the iliac bone was removed with this triangular segment of bone, and a corresponding area of the sacral articular surface was visualized directly. It was possible to remove the rest of the articular cartilage with angled curettes in all specimens. CONCLUSIONS: This approach facilities improved access to the sacroiliac joint for debridement and arthrodesis with minimal soft tissue dissection and iliac bone resection.

Adult↗
PubMed1997

Anterior iliac crest bone graft. Anatomic considerations.

STUDY DESIGN: A morphologic study of the anterior part of the iliac crest was performed. OBJECTIVE: To define the anatomic characteristics of the anterior part of the ilium and to determine an optimal area to harvest the iliac bone graft from the anterior iliac crest. SUMMARY OF BACKGROUND DATA: Stress fracture or avulsion fracture of the anterior cut for anterior iliac crest graft have been noted previously. However, there is insufficient published information on the morphology of the anterior part of the ilium relative to the optimal location of harvesting the bone graft. METHODS: Direct measurements using digital calipers were taken from 30 dried human pelves and 10 cadaveric pelves. The thickness of the anterior part of the ilium was measured, with different starting points on the iliac crest. The length of the bicortical iliac bone graft also was determined. RESULTS: The thickest portion of the ilium was 18.9 +/- 2.3 mm at the iliac tubercle, which was 45% thicker than at a point 3 cm posterior to the anterior superior iliac spine. The thick region of the anterior iliac crest extended 54.0 +/- 10.2 mm posteriorly from a point 3 cm posterior to the anterior superior iliac spine. The mean length of a 10 mm thick bicortical iliac tubercle bone graft was 36.8 +/- 8.7 mm. CONCLUSIONS: The region around the iliac tubercle is suitable for harvesting bicortical or tricortical bone graft.

Bone Transplantation↗
PubMed1999

Can an anomalous lumbo-sacral or lumbo-iliac articulation cause low back pain? A retrospective study of 12 cases.

UNLABELLED: Although anomalous lumbo-sacral articulations are present in 5 to 7% of the population at large, their clinical relevance remains a matter of debate. Articulation between the L5 transverse process and the sacrum or ilium has been implicated as a cause of low back pain. OBJECTIVE: To define symptoms and effects of steroid injections in patients with an articulation between a L5 transverse process and the sacrum or ilium. PATIENTS AND METHODS: Patients with low back pain and an expanded L5 transverse process articulating with the sacrum or ilium were studied retrospectively. Patients with an expanded transverse process that did not articulate with the sacrum or ilium were excluded. Demographic data, symptoms, physical findings and results of investigations were recorded. Efficacy of steroid injections into the anomalous articulation performed under fluoroscopic monitoring was evaluated in the short, medium and long term. RESULTS: Twelve patients (seven men and five women) with a mean age of 41.1 years (17-90 years) and a mean time since symptom onset of 1.9 years (0.2-4 years) were studied. All 12 patients reported pain on the side of the anomalous articulation (left, n = 10), either in the low back (n = 6) or in the buttock (n = 6). Eight patients had pain radiation to all (n = 1) or part (n = 7) of the lower limb on the same side. One patient had mild motor loss (4/5) and another had paresthesia in the foot. Radiographs were obtained in all 12 patients, computed tomography in six, magnetic resonance imaging in two, myelography in two, a bone scan in two and an electromyogram in one. Three of the 11 patients treated by steroid injection experienced pain during the procedure. Ten patients were improved in the short term and nine reported a 50% decrease in their pain after one month. Of the eight patients who were reevaluated after six to 24 months, seven were improved or free of symptoms and one was unchanged. CONCLUSION: An anomalous transitional articulation should be considered as a possible factor in the genesis of low back pain in patients who do not have the degenerative lesions classically responsible for this symptom. Local steroid injections should be tried before surgery is considered.

Adolescent↗
PubMed1993

Morphometric analysis of the pelvis in mice treated neonatally with tamoxifen.

The pelves of male and female C57BL/Tw mice given five daily injection of 100 micrograms tamoxifen, 50 micrograms dihydrotestosterone (DHT), or 2 micrograms diethylstilbestrol (DES) from the day of birth were examined morphometrically and histomorphometrically. Total areas of the pelvis, ilium, ischium, and pubis were significantly smaller in neonatally tamoxifen-treated mice than in the controls. There was no significant difference in length of the ischium between tamoxifen-treated and control mice of both sexes. However, lengths of ilium and pubis, and widths of ilium, pubis, and ischium in tamoxifen-treated male and female mice were significantly smaller than in the respective controls. In contrast, neonatal treatment with DHT or DES did not affect the shape of the pelvis of either sex. In the neonatally tamoxifen-treated females, the number of osteoblasts and osteoclasts per 200 microns trabecular surface length and per 10,000 microns2 subperiosteal area of pubic bone section was smaller than in the controls. Inhibition of ossification persisted in the junction of the pubis and ischium of pelves treated with tamoxifen in vitro. These results suggest that neonatally administered tamoxifen mainly retards the growth of the ilium and pubis in mice by changing the activities of osteoclasts and osteoblasts, and that tamoxifen acts directly on the neonatal mouse pubis to inhibit its ossification.

Animals↗