Lumbar spine evaluation

Boden SD (1996) The use of radiographic imaging studies in the evaluation of patients who have degenerative disorders of the lumbar spine. J Bone Joint Surg Am 78(1 ) 114-124... 

Ca not only works in conjunction with vitamin D to enhance bone health, its effects on bone maintenance have been surmised to be enhanced in postmenopausal women by the presence of other minerals. A 2-year double-blind, placebo-controlled trial evaluated the effect of supplementary Ca (1000 mg elemental Ca/day as CCM) on lumbar spine bone loss in the presence and absence of a combination of trace minerals integral to bone maintenance (i.e., copper, 2.5 mg/day manganese, 5.0 mg/day zinc, 15.0mg/day). Participants included 59 healthy postmenopausal women of mean age ( SD) 66 + 7 years who were on average 18.1 8.9-year postmenopausal (Strause et al, 1994). At baseline, the mean Ca... 

They were randomized to etidronate disodium 200 mg/day for 2 weeks plus calcium lactate 3.0 g/day and alfacalcidol 0.75 micrograms/day) or control (calcium lactate 3.0 g and alfacalcidol 0.75 micrograms/day). Bone mineral density in the lumbar spine and the rate of new vertebral fractures at 48 and 144 weeks were evaluated. With etidronate the mean lumbar spine bone mineral density increased by 3.7% and 4.8% at 48 and 144 weeks respectively. In the control group, the mean lumbar spine bone mineral density increased by 1.5% and 0.4% at 48 and 144 weeks respectively. Of three subgroups, men, premenopausal women, and postmenopausal women, the postmenopausal women had the greatest benefit. Two control patients had new vertebral fractures, whereas there were no fractures with etidronate. 

Hannon et al. (H2) evaluated the response to estrogen substitution therapy after 6 months of treatment by comparing the measurement results with the values before treatment, with respect to the critical differences. The effectiveness of therapy was best followed by the values of osteocalcine and PINP (87% of the results with the drop below the values CD percent). Collagen degradation products U-NTx/Cr and U-CTx/Cr showed only 27% and 18% responses to the treatment, respectively BMD change was significant only for the lumbar spine area in 36% of cases. No answer was reached by measuring the total and femoral value of BMD. 

Items 4-6 A 58-year-old postmenopausal woman was sent for dual-energy x-ray absorptiometry to evaluate the bone mineral density of her lumbar spine, femoral neck, and total hip. The test results revealed significantly low bone mineral density in all sites. 

Spinal lipid. In the spine, Baum et have used H MRS to measure vertebral bone marrow fat content in relation to the volume of abdominal adipose tissue, lumbar spine volumetric bone mineral density, and blood biomarkers in postmenopausal women with and without type 2 diabetes mellitus. Regjs-Arnaud et have compared 2D PRESS and chemical-shift gradient-echo MR imaging for the determination of bone marrow fat in vertebral compression fractures no significant differences were seen in the evaluated fat fractions. 

We evaluated the movement/translation in x- or horizontal direction at LI, showing the overall deformation of the lumbar spine and the translation in x-direction at L5, showing the local disc translation at L5/S1 (Fig. 5). 

Susceptibility factors Inflammatory bowel disease is a susceptibility factor for abnormal bone metabolism, with a large amount of evidence of increased incidences of osteopenia and osteoporosis in adults. However, only a few studies of bone mineral density have been performed in children and adolescents with inflammatory bowel disease. Bone mineral density in the lumbar spine has been evaluated in 40 children and adolescents with inflammatory bowel disease, mean age 12 years, 26 with ulcerative colitis and 14 with Crohn s disease, in order to identify the associated susceptibility factors [15 ]. There was a low bone mineral density (Z-score worse than —2) in 25% of patients, with equal prevalences in Crohn s disease and ulcerative cohtis. Height for age, basal metabolic index, and cumulative glucocorticoid dose had independent effects, and these effects remained significant after adjustment for disease duration. 

The lumbar spine consists of five vertebrae, the largest in size is the spinal column. Most congenital anomalies occur to the fifth lumbar vertebra. Both the thoracic spine and the sacrum and pelvis have significant effects on the posture and function of the lumbar spine. When performing an evaluation of the lumbar spine, it is necessary to include these areas in the examination. 

Gross motion of the lumbar spine is generally evaluated in conjunction with that of the thoracic spine. The patient is standing with his weight evenly distributed and his two feet are spaced 4 to 6 inches apart. The physician kneels or squats directly behind the patient his eyes are level with the lumbar spine. 

Somatic dysfunction of the thorax may occur anteriorly, involving ribs, sternum, or clavicle, or posteriorly, involving costovertebral articulations or the scapulae. Muscle attachments connect the thoracic cage to the cervical spine, the thoracic spine, the lumbar spine, the innominate bones, and the upper extremities. These regions must be evaluated when problems occur in the thoracic cage. 

There are a number of causes for the creation of psoas dysfunction. Among these are trauma to the lumbar spine, lesser trochanter or pubes, myosistis or psoatic bursitis, or visceral dysfunction in relationship to the psoas muscle, such as an acute appendicitis, renal or urethral dysfunctions, fallopian tube inflammation, and iliac or femoral arteiy phlebitis. Any musculoskeletal condition that causes a low back imbalance and lumbar and pelvic somatic dysfunctions must be evaluated. It is important lhat any and all of the findings be actively treated. 

Abumi K, Panjabi M, Kramer KM, Duranceau J, Oxland T, Crisco JJ (1990) Biomechanical evaluation of lumbar spinal stability after graded facetectomies. Spine 15(11) 1142-1147... 

Lazennec, J. Y., Madi, A., Rousseau, M. A., Roger, B. Saillant, G. (2006) Evaluation of the 96/4 PLDLLA polymer resorbable lumbar interbody cage in a long term animal model. European Spine Journal, 15, 1545-1553. 

Glazer, PA Spencer, UM Alkalay, RN Schwardt, J. In vivo evaluation of calcium sulfate as a bone graft substitute for lumbar spinal fusion. Spine Journal, 2001, 1, 395-401. 

Rohmiller, MT Schwalm, D Glattes, RC Elalayli, TG Spengler, DM. Evaluation of calcium sulfate paste for augmentation of lumbar pedicle screw pullout strength. Spine Journal, 2002, 2,255-260. 

To date, the mechanical properties of the metastatic spine and the mechanisms of collapse have not been fuUy elucidated. Moreover, the correlation between vertebral body coUapse and the location and extent of the metastatic tumor is not fully understood. Taneichi et al. (1997) evaluated 100 thoracic and lumbar vertebrae (53 patients) with osteolytic lesions, determined risk factors for vertebral coUapse, and estimated the probability of coUapse under various states of metastatic vertebral involvement. The most important risk factor leading to vertebral coUapse in the thoracic region was involvement of the costovertebral joint. Tumor size within the vertebral body was the second most important risk factor. In-... 

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