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At least 19 recordsLinked to original sources
PubMed1982

Osteoporosis and normality: how to express the bone mineral content of lumbar vertebrae.

Bone mineral content of the 2nd, 3rd, and 4th lumbar vertebrae (lumbar BMC) was measured in 70 normal women (aged 19-88 years) and 72 post-menopausal women (aged 58-89 years) with primary osteoporosis using dual-photon (153Gd) absorptiometry. The inter-individual variation of lumbar BMC was 26.7% in normal women. This figure could be reduced to 13.9%, if lumbar BMC was normalized to age (or years after the menopause), body height, body weight, and vertebral size according to multiple regression analysis. The reduction thus obtained of the inter-individual variation in normal post-menopausal women was statistically insignificant, however, and it appeared that other variables were of importance as the lumbar BMC of older women. Mean lumbar BMC of the osteoporotic women was 41% lower than that of normal pre-menopausal women. The separation between normal and osteoporotic individuals became less clear, if lumbar BMC was normalized as mentioned. The data suggest that spinal osteoporosis is predominantly a condition of normal small old women with diminutive vertebrae and early menopause. It is recommended that lumbar BMC is expressed as the total mineral mass of the bones measured, the normal range being BMC of health pre-menopausal women. Normalization to age, body height, body weight, and vertebral size seems rather speculative.

Adult↗
PubMed1992

Burst fracture of the fifth lumbar vertebra.

Burst fracture of the fifth lumbar vertebra is a rare injury. We report the cases of seven patients who were treated conservatively by immobilization for six to eight weeks in a body-jacket cast that included one lower extremity to the knee. The patients were allowed to walk ten to fourteen days after the injury. A thoracolumbosacral orthosis was worn for an additional three months. No patient had an injury to the sacral root. Two patients had mild lower lumbar motor-root deficits that resolved within one year. All patients had an occasional backache, and two had intermittent radicular-type pain in the distribution of the fifth lumbar or first sacral-nerve root. The degree of compromise of the spinal canal could not be directly related to the degree of neurological deficit; that is, a large compromise of the spinal canal did not necessarily result in a major loss of neurological function. There was no early or late loss of lordosis between the cephalad end-plate of the fourth lumbar vertebra and the cephalad aspect of the sacrum, and there were no signs of progressive collapse of the vertebral body in any patient. In our series, the burst fractures of the fifth lumbar vertebra were stable injuries that caused minimum neurological deficits, and treatment by immobilization in a body-jacket cast was effective.

Adult↗
PubMed1995

Laparoscopic approaches to the lumbar vertebrae. An anatomic study using a porcine model.

STUDY DESIGN: This study described and compared retroperitoneal and transperitoneal laparoscopic approaches to the lumbar vertebrae in pigs. Technical and perioperative complications were evaluated for each approach. OBJECTIVES: The objective of this study was to develop a laparoscopic approach to the lumbar vertebrae that is associated with minimal technical and perioperative complications. SUMMARY OF BACKGROUND DATA: Laparoscopic techniques have been used extensively in many surgical fields. Recently, thoracoscopy has been used to perform a number of thoracic spinal procedures, including thoracic discectomy, and anterior osteotomy, release, and fusion. To date, there have been no published reports describing laparoscopic approaches to the lumbar vertebrae. METHODS: With all pigs positioned in left lateral recumbency, retroperitoneal and transperitoneal laparoscopic approaches to the lumbar vertebrae were performed in three pigs. Placement of the insufflation needles and trocar ports were determined for each approach. Dissection of the lumbar vertebrae were performed, and the technical and perioperative complications recorded. Radio-opaque markers were placed to identify the dissected lumbar intervertebral disc spaces, and intraoperative fluoroscopy was used to confirm marker placement. Gross anatomic dissections were performed after the pigs were killed. RESULTS: Loss of pneumoretroperitoneum resulted in surgical termination in two of three pigs undergoing retroperitoneal laparoscopic approach to the lumbar vertebrae. In the remaining pig, difficulty was encountered in mobilization of the psoas major muscle from the lumbar vertebrae, and significant bleeding occurred. The transperitoneal approach to the lumbar vertebrae resulted in rapid mobilization of the psoas musculature and exposure of the lumbar vertebral bodies and discs of L1-L6/L7. Intraoperative complications included minimal bleeding and difficulty encountered in mobilization of the renal vascular pedicle. CONCLUSIONS: The retroperitoneal approach was difficult because of the degree of muscle dissection required for exposure of the lumbar vertebrae. Complications associated with the retroperitoneal approach included loss of pneumoretroperitoneum because of entry into the peritoneal cavity, hemorrhage, and limited exposure of the lumbar vertebrae. The transperitoneal approach was easier technically, allowing identification and access to lumbar vertebral bodies and intervertebral discs from L1-L6/L7. Operative complications associated with the transperitoneal laparoscopic approach were minimal.

Animals↗
PubMed2005

Conservative management of burst fractures of the fifth lumbar vertebra.

Isolated fractures of the lumbar fifth vertebrae (L5) are very rare, and there is little information in the literature regarding comparisons between conservative management and surgical treatment of this entity. This retrospective analysis reports on five cases of isolated burst fractures of the fifth lumbar vertebra without neurologic deficit. All cases were managed nonoperatively with a short period of bed rest followed by protected mobilization. The current study reveals that conservative management is appropriate in the cases of burst fractures of the fifth lumbar vertebra with minimal canal compromise, with little deformity, and without neurologic damage.

Adult↗
PubMed2001

Quantitative three-dimensional anatomy of lumbar vertebrae in Singaporean Asians.

This paper details the quantitative three-dimensional anatomy of lumbar vertebrae L1-L5 from Asian (Singaporean) subjects based on 60 lumbar vertebrae from 12 cadavers. The purpose of the study was to measure the dimensions of the various parameters of the lumbar vertebrae and thereafter to compare the data with a study performed on Caucasian specimens. Measurements were taken with the aid of a three-dimensional digitiser. The means and standard errors for linear, angular and area dimensions of the vertebral body, spinal canal, pedicle, and spinous and transverse processes were obtained for each lumbar vertebra. From this comparison, it was found that the dimensions of the vertebral body of the Asian subjects are slightly larger, with a maximum average difference of 8% for the posterior vertebral body height. The dimensions of the spinal canal, pedicle, and spinous and transverse processes of Asian subjects are smaller. The greatest difference can be found in the spinal canal area and pedicle width, which are smaller by an average of 30% and 20%, respectively. With the exception of the spinal canal depth, spinal canal area and pedicle width, all other parameters compared show a similar trend. The findings can provide more accurate modelling for analysis and spinal implant design and also allow more precise clinical diagnosis in sub-Asian groups.

Aged↗
PubMed2000

Geometrical dimensions of the lower lumbar vertebrae--analysis of data from digitised CT images.

The precise dimensions of the lumbar vertebrae and discs are critical for the production of appropriate spinal implants. Unfortunately, existing databases of vertebral and intervertebral dimensions are limited either in accuracy, study population or parameters recorded. The objective of this study is to provide a large and accurate database of lumbar spinal characteristics from 126 digitised computed tomographic (CT) images, reviewed using the Picture Archiving Communication System (PACS) coupled with its internal measuring instrumentation. These CT images were obtained from patients with low back pain attending the spinal clinic at the Hammersmith Hospitals NHS Trust. Measurements of various aspects of vertebral dimensions and geometry were recorded, including vertebral and intervertebral disc height. The results from this study indicated that the depth and width of the vertebral endplate increased from the third to the fifth lumbar vertebra. Anterior vertebral height remained the same from the third to the fifth vertebra, but the posterior vertebral height decreased. Mean disc height in the lower lumbar segments was 11.6 +/- 1.8 mm for the L3/4 disc, 11.3 +/- 2.1 mm for the L4/5, and 10.7 +/- 2.1 mm for the L5/S1 level. The average circumference of the lower endplate of the fourth lumbar vertebra was 141 mm and the average surface area was 1,492 mm2. An increasing pedicle width from a mean of 9.6 +/- 2.2 mm at L3 through to 16.2 +/- 2.8 mm at L5 was noted. A comprehensive database of vertebral and intervertebral dimensions was generated from 378 lumbar vertebrae from 126 patients measured with a precise digital technique. These results are invaluable in establishing an anthropometric model of the human lumbar spine, and provide useful data for anatomical research. In addition this is important information for the scientific planning of spinal surgery and for the design of spinal implants.

Adult↗
PubMed1992

[Determination of vertebral fracture threshold by measuring bone mineral content in the lumbar vertebrae].

Bone mineral density (BMD) in the lumbar vertebrae (L2-L4) was assessed by dual energy X-ray absorptiometry (DEXA: QDR-1000), and the values obtained were compared with the frequency of vertebral fracture as assessed by spinal X-ray photographs. Patients with spondylosis or scoliosis, which affect BMD values, were excluded from the study. An essentially linear correlation was observed between the frequency of vertebral fracture and lumbar BMD values: no vertebral fractures were observed in those whose BMD more than 0.8 g/cm2, whereas the frequency of fracture was 100% in patients whose BMD was less than 0.45 g/cm2. Thus, measurement of lumbar vertebrae by DEXA would be very useful in predicting vertebral fractures.

Absorptiometry, Photon↗
PubMed2006

[Assessment of bone density in children and adolescents by quantitative CT of one lumbar vertebra only].

AIM: The aim of this study was to determine whether measuring the trabecular bone density in one lumbar vertebra (L) instead of three has an effect on the assessment of bone density in children. MATERIALS AND METHODS: Bone density was measured in 70 patients (38 male, 32 female), ages 1 to 22 years (mean age 12.4, median 13 years) using a Somatom Balance Scanner (Siemens). The trabecular bone density was measured (1-cm slice, 80 kV, 81 mAs) in L1 through L3. RESULTS: The mean bone density in the lumbar vertebrae was 139.9 mg/ml calcium-hydroxylapatite per ml bone in L1, 133.9 in L2, and 131.7 in L3, and the mean of all three vertebrae was 135.2 mg/ml. Measurements in L1 were 4.7 mg/ml (standard deviation [SD] 4.7 mg/ml) above the mean value of the three upper lumbar vertebrae. The density in L2 was 1.3 mg/ml below the mean (SD 3.1 mg/ml). On average, L3 was 3.5 mg/ml below the mean (SD 4.6 mg/ml). This minor systematic deviation in the measurement values for the individual vertebrae from the mean value was so low that there was no statistical evidence for a deviation from an ideal regression line. CONCLUSIONS: When using an adequate technique, especially accurate analysis of the topogram (scout view) and the tomogram, measurement of the bone density of one lumbar vertebra provides satisfactory information regarding the trabecular bone density in children, but the values differ in the three upper lumbar vertebrae. The bone density of L2 is close to the mean of the upper three vertebrae. In the case of pathologic values or a pathologic trabecular pattern, three vertebrae should be measured.

Absorptiometry, Photon↗
PubMedDate not supplied

The bone mineral content and ultimate compressive strength of lumbar vertebrae.

The bone mineral content of 109 lumbar vertebrae from 36 different subjects was determined by dual photon absorptiometry. The mean age of the subjects was 58.5 years (range, 31 to 79 years). The ultimate strength of the vertebral bodies was determined during axial compression. Bone mineral content and ultimate compressive strength were correlated (r = 0.86) and the strength was found to increase linearly with increasing amounts of bone mineral content. No differences in this correlation were found in the four vertebral levels (L-4) included in the study, but a difference in this correlation was found between specimens taken from male and female subjects. The results make it possible to estimate the strength of a vertebral body from the knowledge of its bone mineral content as determined by dual photon absorptiometry and provide a basis of estimations of normal and abnormal amounts of bone mineral content in the vertebrae of the lumbar spine.

Adult↗
PubMed2002

[Experiment study on stress relaxation and creep of spinal lumbar vertebrae (T12-L5) by simulating operations of excising lumbar disc intervertebrales by the front route and by the back route].

We have studied the characteristics of stress relaxation and creep on lumbar vertebrae(T12-T5) of 18 fresh corpses. We measured the stress relaxation and creep of the normal group(intact spine), the control group 1(simulating the operations by the front route) and the control group 2(simulating the operations by the back route). Then we obtained the stress, strain-time curves and data under the conditions of constant stress and strain. By using regression analysis we obtained the reduced stress relaxation and creep functions. Finally, We analyzed and discussed the effects of the operations of excising the disc intervertebrales by the front route and the back route.

Diskectomy↗
PubMed1980

[The structure of the spongy bone in lumbar vertebrae and the neck of the femur. A comparative analysis of the age-dependent remodelling process (author's transl)].

In 114 autopsy cases of both sexes, aged between 31 and 97 years and without bone disease, the influence of mechanical forces on the age-dependent remodelling of the spongy bone was determined in the 3rd and 5th lumbar vertebrae and the neck of the femur. For this purpose contrasty X-ray images of 100 mu thick polished bone sections were analysed using the LEITZ texture analysis system. The volumetric density and the surface density are highest in the neck of the femur, lowest in the 3rd lumbar vertebra, and almost as low in the 5th lumbar vertebra. The volumetric density decreases with increasing age by about one-third in all three bones. Correspondingly, the surface density also decreases in the lumbar vertebrae by one-third, but only by 18% in the neck of the femur. The specific surface reveals no age differences in the lumbar vertebrae, but increases by 19% in the neck of the femur. The constancy of the specific surface in the lumbar vertebrae can be explained by the fact that compensatory hypertrophy of the remaining trabeculae takes place. This compensatory growth of bone does not occur in the neck of the femur. The age-dependent decrease in spongy bone manifests itself in a residual spongiosa structure that depends on compressive forces in the case of the lumbar vertebrae and bending forces in the neck of the femur.

Adult↗
PubMed1979

The compressive strength of lumbar vertebrae.

Values for the compressive breaking load of lumbar vertebrae at physiological strain rates show enormous scatter across the population, ranging from 0.8 kN to nearly 16 kN. Increase in strength was found at faster strain rates, but differences in compressive strength between upper and lower lumbar vertebrae were not significant. Hydraulic strengthening does not appear to contribute to the compressive strength at the strain rates studied.

Adolescent↗
PubMed1989

Congenital malformation and variation of the lumbar vertebrae in a dog.

The clinical, radiological and anatomical changes in a 6 1/2-month-old Fox Terrier bitch with congenital malformation and variation of the lumbar vertebrae are described. The dog has 5 lumbar vertebrae and the first lumbar vertebra was malformed resulting in a dorsal hemivertebra, kyphosis and spinal cord compression. The possible pathogenesis of the dorsal hemivertebra is mentioned.

Animals↗