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At least 163 records · Page 9Linked to original sources
PubMed1985

Vertebral artery occlusion at the narrowed "scalenovertebral angle": mechanical vertebral occlusion in the distal first portion.

We report a patient who developed occasional vertigo when turning his head to the right side. Occlusion of the right vertebral artery occurred at the narrowed "scalenovertebral angle" with this rotational head movement. This triangular tunnel consisted of the hypertrophied ligament of the longus colli muscle and the anterior scalene muscle. Decompression of these extraluminal compressive factors led to relief of the symptoms. Two different kinds of extrinsic compression at the first portion of the vertebral artery are discussed.

Arterial Occlusive Diseases↗
PubMed1982

Medicare program; conditions for Medicare coverage of surgery to relieve obstructions to vertebral artery blood flow (vertebral artery surgery)--Health Care financing Administration. Notice of HCFA ruling.

This notice announces a HCFA ruling that restates Medicare policy on coverage of vertebral artery surgery. Medicare covers medical procedures only if the procedures are safe and effective. Available evidence shows that five types of surgical procedures performed to relieve an obstruction of the vertebral artery blood flow are safe and effective, but only if each of four conditions is met.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2001

[Blood flow of the vertebral artery in cases of pontine high intensity area identified by T2-weighted MRI--a study with ultrasonography of vertebral arteries].

Ultrasonography of vertebral arteries (Duplex method) was conducted in cases of pontine high intensity area identified by T2-weighted MRI. Patients complaining headache, vertigo and dizziness were classified into two groups: 19 cases with pontine high intensity area; and 58 cases of control without abnormality in the pons. In comparison with the control, the cases with pontine high intensity area had lower minimum diastolic flow velocity and stroke volume in the dominant vertebral artery, suggesting the presence of basilar artery insufficiency. These findings may support previous data that pontine high intensity area represents diffuse ischemia in the brainstem.

Aged↗
PubMed2003

Perfusion- and diffusion-weighted MR imaging-guided therapy of vertebral artery dissection: intraarterial thrombolysis through an occipital vertebral anastomosis.

Management of arterial dissections can be particularly challenging. We report a case of vertebral artery dissection in which perfusion- and diffusion-weighted MR imaging findings suggested the presence of salvageable tissue, despite that the patient had symptoms for more than 40 hours. Direct access to the distal vascular territory was unattainable, and the presence of collateral circulation through an occipital vertebral anastomosis provided the only pathway to administer intraarterial thrombolysis. This case demonstrates that perfusion- and diffusion-weighted MR imaging can be instrumental in the selection of candidates for aggressive stroke therapy. Arterial anastomoses can provide alternate access to ischemic vascular beds and merit careful evaluation during intraarterial thrombolysis.

Acute Disease↗
PubMed2005

[Effect of vertebral manipulation therapy on vertebro-basilar artery blood flow in cervical spondylosis of vertebral artery type].

OBJECTIVE: To observe the effect of vertebral manipulation (VM) therapy on vertebro-basilar artery (VBA) blood flow in patients with cervical spondylosis of vertebral artery type (CS-VAT) by transcranial Doppler (TCD) ultrasonic examination. METHODS: One hundred and fifty patients with CS-VAT were randomized into the VM group (n = 100) and the acupuncture group (n = 50), and treated for ten times as one therapeutic course. Changes of the contraction peak, the end-diastolic and average blood flow velocity of VBA before and after treatment in the two groups were observed and compared by TCD. RESULTS: Vp, Vd, Vm of LVA, RVA and BA in the two groups after treatment were all lowered, showing significant difference, excepting Vp of VBA in the acupuncture group, when compared with before treatment (P< 0.05 or P <0.01). Comparison between the two groups after treatment showed significant difference in Vp and Vm of LVA, Vp, Vd and Vm of RVA, Vp and Vm of VBA respectively (P<0.05, P <0.01). CONCLUSION: VM therapy in treating patients with CS-VAT shows therapeutic effect superior to VA therapy, which could significantly improve VBA blood flow.

Adult↗
PubMed1989

[Surgical treatment of extracranial occlusive processes of the vertebral artery by construction of a subclavio-vertebral bypass].

An account is given of causes and clinical patterns of vertebro-basilar insufficiency, before reference is made to patients treated at the Surgical Department of Charité to describe indications for surgery, diagnostic approach, and various surgical techniques. A particular role is played, in this context, by stenoses and occlusions of the vertebral artery in the bone canal of the cervicovertebral column. Subclavio-vertebral bypass is a new surgical technique recommended for surgical treatment of that kind of vascular processes.

Adult↗
PubMed1995

Differences in the characteristics of responders and non-responders in a prevalence survey of vertebral osteoporosis. European Vertebral Osteoporosis Study Group.

Men and women aged 50 years and over were recruited for participation in a population-based prevalence survey of vertebral osteoporosis from 36 centres in 19 European countries. All subjects were invited to attend by letter of invitation for a "lifestyle" interview and lateral spinal radiograph. The aim of this analysis was to investigate how far those who agreed to attend were representative of the target population and thus whether any important level of non-response bias existed. To address this a second invitation was sent to all non-responders and, in 20 centres, a sample of ultimate non-responders was contacted by mail, telephone or home visit and given a shortened version of the lifestyle questionnaire. Compared with the sample of non-responders, responders might be considered less at risk from osteoporosis in that as a group they took more exercise and were less likely to be current smokers. Other factors suggested the contrary in that they consumed less calcium and were more likely to have suffered a previous fracture. Amongst responders, these factors appeared also to be related to the timing of response. Thus compared with delayed responders, those who participated after a first letter of invitation took more exercise, were less likely to be smokers and more likely to have suffered a previous fracture. However, in contrast to the results suggested by the non-response survey early responders consumed more calcium than late responders. The magnitude of the differences between responders and non-responders was small (less than 10% for most of the categorical variables) and the differences were not consistently in the direction of an increased or decreased risk of osteoporosis. Additionally the size or direction of these differences was not consistently influenced by the response rate based on classifying centres into those with a high, medium or low response rate. This suggests that in this multicentre study response bias probably does not have a major influence on the prevalence estimates of vertebral fracture. In epidemiological studies of osteoporosis comparison of the lifestyle differences between early and late responders provides useful information concerning response characteristics.

Aged↗
PubMed2006

Balloon kyphoplasty for vertebral compression fractures in solid organ transplant recipients: results of treatment and comparison with primary osteoporotic vertebral compression fractures.

BACKGROUND CONTEXT: Balloon kyphoplasty has become established as a useful treatment for vertebral compression fractures (VCF) associated with primary osteoporosis and osteolytic tumors. Organ transplant recipients are also at risk for VCF because of their underlying disease process and because they require long-term treatment with steroids and other immunosuppressive drugs. PURPOSE: To explore whether balloon kyphoplasty is an effective treatment for VCF that develop in solid organ transplant recipients. A secondary goal was to determine whether there are any differences between VCF in transplant patients and VCF in patients with primary osteoporosis, with respect to disease severity and new fracture development. STUDY DESIGN: Prospective, longitudinal clinical series. PATIENT SAMPLE: The transplant group included 10 consecutive transplant patients (9 liver and 1 kidney), with a total of 29 symptomatic VCFs. The comparison group included 10 consecutive patients with primary osteoporosis and no history of organ transplantation, with a total of 15 VCFs. OUTCOME MEASURES: The primary clinical end point was back pain, measured using the Visual Analog Scale (VAS), which was recorded at baseline, and 1 and 12 months postprocedure. Radiographic evaluation included measurement of Cobb angles for each treated vertebral segment on preprocedure and 1-month postprocedure lateral radiographs. An improvement of >5 degrees was considered significant. The number of fractures seen at the time of diagnosis and the number of new fractures occurring during the follow-up period were recorded. METHODS: Balloon kyphoplasty was performed at all symptomatic levels. All fractures were treated within 3 months of onset. Patient follow-up was 12 months. RESULTS: The transplant group had significantly higher levels of pain at baseline, (mean VAS 9.3 and 7.7 for the transplant group and primary osteoporosis group, respectively: p=.013). After treatment, the VAS decreased to 3.2 in the transplant group and 1.5 in the comparison group. Improvement was highly significant in both groups (p<.001), and was maintained at 12-month follow-up. Sagittal alignment was improved by >5 degrees in three patients in each group (30%). There were no procedural complications in either group. Compared with the primary osteoporosis group, the transplant group was more likely to have multiple fractures at the time of diagnosis (2.9 vs. 1.5, p=.03), had a twofold greater incidence of new fractures during the follow-up period (40% vs. 20%), was more than a decade younger (64 vs. 75 years, p<.01), was much more likely to have received chronic immunosuppressive therapy with glucocorticoids and calcineurin phosphate inhibitors (100% vs. 0%, p<.001), and had a higher percentage of males (70% vs. 10%, p=.02), CONCLUSIONS: These data suggest that balloon kyphoplasty can be performed safely in organ transplant recipients with VCFs. The degree of pain relief is equivalent to that seen in patients with primary osteoporosis. Results are durable at 12-month follow-up. Transplant patients developed earlier and more severe bony disease, with more severe baseline pain, a higher incidence of multiple fractures at the time of diagnosis, and a greater risk of new fracture development posttreatment, as compared with the primary osteoporosis group.

Aged↗
PubMed1985

Extra-intracranial bypass surgery for vertebrobasilar insufficiency due to obstructive vertebral artery and vertebral-basilar artery junction disease.

This report is on 19 patients with vertebrobasilar insufficiency in whom direct extra-intracranial arterial bypass surgery to the posterior circulation was performed. In all patients preoperative angiography had demonstrated vascular lesions of haemodynamic significance of either one or both vertebral arteries (VA) or within the vertebral-basilar artery junction (VABAJ). The bypass procedure was performed between the occipital artery (OA) and - depending on the localization of the obstructive vascular lesion - the posterior inferior cerebellar artery (PICA), the VA or the anterior inferior cerebellar artery (AICA). A modification of the operative technique is presented with using a paramedian approach. The clinical results of this series support the concept that a patent extra-intracranial graft to the posterior circulation may have a protective effect by preventing further ischaemic events.

Adult↗
PubMed2004

Polymorphisms in the low-density lipoprotein receptor-related protein 5 (LRP5) gene are associated with variation in vertebral bone mass, vertebral bone size, and stature in whites.

Stature, bone size, and bone mass are interrelated traits with high heritability, but the major genes that govern these phenotypes remain unknown. Independent genomewide quantitative-trait locus studies have suggested a locus for bone-mineral density and stature at chromosome 11q12-13, a region harboring the low-density lipoprotein receptor-related protein 5 (LRP5) gene. Mutations in the LRP5 gene were recently implicated in osteoporosis-pseudoglioma and "high-bone-mass" syndromes. To test whether polymorphisms in the LRP5 gene contribute to bone-mass determination in the general population, we studied a cross-sectional cohort of 889 healthy whites of both sexes. Significant associations were found for a missense substitution in exon 9 (c.2047G-->A) with lumbar spine (LS)-bone-mineral content (BMC) (P=.0032), with bone area (P=.0014), and with stature (P=.0062). The associations were observed mainly in adult men, in whom LRP5 polymorphisms accounted for <or=15% of the traits' variances. Results of haplotype analysis of five single-nucleotide polymorphisms in the LRP5 region suggest that additional genetic variation within the locus might also contribute to bone-mass and size determination. To confirm our results, we investigated whether LRP5 haplotypes were associated with 1-year gain in vertebral bone mass and size in 386 prepubertal children. Significant associations were observed for changes in BMC (P=.0348) and bone area (P=.0286) in males but not females, independently supporting our observations of a mostly male-specific effect, as seen in the adults. Together, these results suggest that LRP5 variants significantly contribute to LS-bone-mass and size determination in men by influencing vertebral bone growth during childhood.

Adolescent↗
PubMed1999

Analysis of the chicken TBP-like protein(tlp) gene: evidence for a striking conservation of vertebrate TLPs and for a close relationship between vertebrate tbp and tlp genes.

TLP (TBP-like protein), which is a new protein dis-covered by us, has a structure similar to that of the C-terminal conserved domain (CCD) of TBP, although its function has not yet been elucidated. We isolated cDNA and genomic DNA that encode chicken TLP (cTLP) and determined their structures. The predicted amino acid sequence of cTLP was 98 and 91% identical to that of its mammalian and Xenopus counterparts, respectively, and its translation product was ubiquitously observed in chicken tissues. FISH detection showed that chicken tlp and tbp genes were mapped at 3q2.6-2.8 and 3q2.4-2.6 of the same chromosome, respectively. Genome analysis revealed that the chicken tlp gene was spliced with five introns. Interestingly, the vertebrate tbp genes were also found to be split by five introns when we focused on the CCDs, and their splicing points were similar to those of tlp. On the contrary, another TBP-resembling gene of Drosophila, trf1, is split by only one intron, as is the Drosophila 's tbp gene. These results support our earlier assumption that vertebrate TLPs did not directly descend from Drosophila TRF1. On the basis of these results together with phylogenetical exam-ination, we speculate that tlp diverged from an ancestral tbp gene through a process of gene duplication and point mutations.

Amino Acid Sequence↗
PubMed1989

Placement of transpedicular vertebral screws close to anterior vertebral cortex. Description of methods.

Strengthening of the screw-vertebra interface has been shown to occur with implantation of longer transpedicular screws, the tips of which are placed closer to the anterior cortex of the vertebral body. Such implantation probably results in increased risk for anterior cortex penetration and associated vascular or pulmonary damage. Typically recommended lateral and posterior-anterior radiography is shown here to provide potentially misleading visualization during implantation. To reduce the risk of anterior cortical penetration, presented here are 1) a radiographic method ("near approach view") that avoids this problem and allows direct visualization of the relationship between drill bit or screw tip and anterior vertebral cortex, and 2) a surgical technique ("mallet method") that provides both an audible and a palpable change when the drill bit contacts the anterior cortex.

Bone Screws↗
PubMed2001

Osteoporosis changes the amount of vertebral trabecular bone at risk of fracture but not the vertebral load distribution.

STUDY DESIGN: A finite-element study to investigate the amount of trabecular bone at risk of fracture and the distribution of load between trabecular core and cortical shell, for healthy, osteopenic, and osteoporotic vertebrae. OBJECTIVES: To determine differences between healthy, osteopenic, and osteoporotic vertebrae with regard to the risk of fracture and the load distribution. SUMMARY OF BACKGROUND DATA: The literature contains no reports on the effects of osteopenia and osteoporosis on load distribution in vertebral bodies, nor any reports on the amount of trabecular bone at risk of fracture. METHODS: Computed tomography data of vertebral bodies were used to construct patient-specific finite-element models. These models were then used in finite-element analyses to determine the physiologic stresses and strains in the vertebrae. RESULTS: For all three classes of vertebrae the contribution of the trabecular core to the total load transfer decreased from about 70% near the endplates to about 50% in the midtransverse region. The amount of trabecular bone that is at risk of fracture was about 1% for healthy vertebrae, about 3% for osteopenic vertebrae, and about 16% for osteoporotic vertebrae. CONCLUSIONS: Our finite-element models indicated that neither osteopenia nor osteoporosis had any effect on the contribution of the trabecular core to the total load placed on the vertebra. The trabecular core carried about half the load. Our finite-element models indicated that osteoporosis had a significant effect on the amount of trabecular bone at risk of fracture, which increased from about 1% in healthy vertebrae to about 16% for osteoporotic vertebrae.

Adult↗
PubMed2002

V-SINEs: a new superfamily of vertebrate SINEs that are widespread in vertebrate genomes and retain a strongly conserved segment within each repetitive unit.

We have identified a new superfamily of vertebrate short interspersed repetitive elements (SINEs), designated V-SINEs, that are widespread in fishes and frogs. Each V-SINE includes a central conserved domain preceded by a 5'-end tRNA-related region and followed by a potentially recombinogenic (TG)(n) tract, with a 3' tail derived from the 3' untranslated region (UTR) of the corresponding partner long interspersed repetitive element (LINE) that encodes a functional reverse transcriptase. The central domain is strongly conserved and is even found in SINEs in the lamprey genome, suggesting that V-SINEs might be approximately 550 Myr old or older in view of the timing of divergence of the lamprey lineage from the bony fish lineage. The central conserved domain might have been subject to some form of positive selection. Although the contemporary 3' tails of V-SINEs differ from one another, it is possible that the original 3' tail might have been replaced, via recombination, by the 3' tails of more active partner LINEs, thereby retaining retropositional activity and the ability to survive for long periods on the evolutionary time scale. It seems plausible that V-SINEs may have some function(s) that have been maintained by the coevolution of SINEs and LINEs during the evolution of vertebrates.

Amino Acid Sequence↗
PubMed1990

Cervical vertebral dislocation in a rugby player with congenital vertebral fusion.

Congenital cervical vertebral fusion is an anomaly which decreases the normal range of spinal movement and predisposes to trauma. The case history of a rugby player with a congenital fusion who sustained permanent quadriplegia after dislocation of the lower cervical spine is presented. The mechanism of injury is discussed. A plea is made for routine radiographic examination of the cervical spines of all rugby players in order to detect the presence of vertebral fusion and other conditions which may predispose to spinal trauma.

Adult↗
PubMed2005

Immediate and early postoperative pain relief after kyphoplasty without significant restoration of vertebral body height in acute osteoporotic vertebral fractures.

OBJECT: Painful osteoporotic vertebral compression fractures (VCFs) are a significant cause of disability in the elderly population. Kyphoplasty, a recently developed minimally invasive procedure, has been advocated for the successful management of these fractures in terms of immediate pain relief, and also for restoration of the premorbid level of daily activities. In this retrospective study the authors report on their experience with the early management of VCFs with kyphoplasty. METHODS: A retrospective analysis was conducted in 13 patients (seven women and six men) whose ages ranged from 48 to 87 years (mean age 71.5 +/- 11 years [mean +/- standard deviation]). The interval between onset of symptoms and surgical intervention ranged from 4 to 9 weeks. Twenty levels (12 thoracic, eight lumbar) were treated in this cohort. Immediate and early postoperative (1-month follow-up visit) visual analog scale (VAS) pain scores, activity levels, and restoration of vertebral body (VB) height were assessed. The mean preoperative VAS score was 8 +/- 1, whereas the immediate and early postoperative scores were 1 +/- 1. These findings reflected a resolution of 90 to 100% of preoperative pain. All patients resumed routine activities within hours of the procedure, although improvement in VB height was not accomplished in this cohort. No major complications were encountered in this clinical series. CONCLUSIONS: Kyphoplasty is a safe and effective method for the treatment of osteoporotic VCFs. Failure to restore VB height does not seem to interfere with the excellent pain management and good functional outcome provided by this procedure.

Aged↗
PubMed2000

New dysostosis showing multilevel absence of vertebral pedicles: unique developmental anomaly of vertebral arches?

We report on an apparently normal child who shows hypopaplasia of the vertebral pedicles and posterior arches of several cervical, thoracic, and lumbar vertebrae with normally fused spinous apophyses, hypoplastic sacrum, lumbar epidural lipomatosis, synostoses of some cervical vertebral disks, and sacral spina bifida. The most likely mechanism is an abnormal differentiation of the spinal processes, due most probably to an absence of differentiation in cartilage of the dense mesenchyme forming their most anterior part. Because the anomalies affect multiple levels, we highly suspect a genetic basis to this unusual dysostosis affecting the development of the posterior sclerotomes.

Adult↗
PubMed1992

[Vertebral fractures and abdominal trauma. A retrospective study based on 415 documented vertebral fractures].

415 spinal fractures were analysed retrospectively. A simultaneous occurrence of vertebral fracture and abdominal trauma was found in 14 patients (3.4%). The mechanism of injury was a fall from a considerable height in 9 cases, a car accident in 3 and a motorcycle accident in 2. Isolated fractures of the transverse processes and rotational injuries of the spine were found to be associated particularly frequently with an abdominal trauma (3 of 14 isolated fractures of the transverse processes = 22%, 5 of 61 rotational injuries = 8.2%), while compression injuries only showed such a simultaneous abdominal injury in 2% of the 300 fractures of this type. We never encountered the combination of distraction injury/abdominal trauma. This is probably because two-point lap-type seat belts are only rarely used in our country. In 2 patients with rotational injuries neurological deficits were observed. The abdominal injuries encountered in our patients were: massive concussion of the kidney (6 cases), rupture of the spleen (3 cases), rupture of the liver (2 cases), rupture of the mesocolon (2 cases), rupture of the caecum (1 case), rupture of a pre-existent aneurysm of the aorta (1 case), rupture of a renal artery (1 case), massive retroperitoneal haematoma (1 case). Other injuries were present in 12 of the 14 patients: 3 craniocerebral injuries, 7 fractures of the long bones, 6 injuries to the thorax and 3 to the pelvis. In conclusion, a simultaneous finding of vertebral fracture and abdominal trauma is rare in our patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Injuries↗