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Lumbar Spine CT

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1. Is Routine MRI of the Spine Necessary in Trauma Patients with Ankylosing Spinal Disorders or is a CT Scan Sufficient? (Abstract)

Is Routine MRI of the Spine Necessary in Trauma Patients with Ankylosing Spinal Disorders or is a CT Scan Sufficient? Ankylosing spinal disorder (ASD) patients are at a greater risk for spinal fractures due to osteoporosis and rigidity of the spinal column. These fractures are associated with a high risk of neurologic compromise resulting from delayed or missed diagnoses. Although computed tomography (CT) is usually the initial imaging modality, magnetic resonance imaging (MRI) has been (...) . Secondarily, we attempted to identify clinical or CT findings that may render an MRI particularly useful.Retrospective review.Patients with ASD who sustained acute spine fractures from 2005 to 2015.Acute fractures identified by CT scan and MRI upon admission; neurologic status upon admission and discharge, mode of injury, type of fracture, and final intervention before and after MRI assessment.A total of 124 patients with a diagnosis of diffuse idiopathic skeletal hyperostosis (DISH) or ankylosing

2019 The Spine Journal

2. Pedicle screw insertion with patient-specific 3D-printed guides based on low-dose CT scan is more accurate than free-hand technique in spine deformity patients: a prospective, randomized clinical trial. (Abstract)

Pedicle screw insertion with patient-specific 3D-printed guides based on low-dose CT scan is more accurate than free-hand technique in spine deformity patients: a prospective, randomized clinical trial. Screw misplacement incidence can be as high as 15-30% in spine deformity surgery, with possible devastating consequences. Some technical solutions to prevent misplacement require expensive devices. MySpineTM comprises a low-dose CT scan of the patient's spine to build a virtual model (...) of the spine to plan the screw trajectories and a 3D-printed patient-specific guide system to prepare the screw trajectories and to implant the screws in the vertebrae in order to increase reproducibility and safety of the implants. The aim of this open-label, single-center, prospective randomized clinical trial with independent evaluation of outcomes was to compare the accuracy of free-hand insertion of pedicle screws to MySpineTM 3D-printed patient-specific guides.Twenty-nine patients undergoing surgical

2019 European Spine Journal Controlled trial quality: uncertain

3. ACR–ASNR–ASSR–SPR Practice Parameter for the Performance of Computed Tomography (CT) of the Spine

. Comparison of CT myelography performed in the prone and supine positions in the detection of cervical spinal stenosis. Clin Radiol. 2001;56(1):35-39. 17. Falco FJ, Moran JG. Lumbar discography using gadolinium in patients with iodine contrast allergy followed by postdiscography computed tomography scan. Spine (Phila Pa 1976). 2003;28(1):E1-4. 18. Ilkko E, Lahde S, Heiskari M. Thin-section CT in the examination of cervical disc herniation. A prospective study with 1-mm axial and helical images. Acta (...) . [Helical CT for lumbosacral spinal]. Nippon Igaku Hoshasen Gakkai Zasshi. 1996;56(12):822-827. 23. Mirza SK, Wiggins GC, Kuntz Ct, et al. Accuracy of thoracic vertebral body screw placement using standard fluoroscopy, fluoroscopic image guidance, and computed tomographic image guidance: a cadaver study. Spine (Phila Pa 1976). 2003;28(4):402-413. 10 / CT_Spine PRACTICE PARAMETER 24. Tsuchiya K, Katase S, Aoki C, Hachiya J. Application of multi-detector row helical scanning to postmyelographic CT. Eur

2019 American Society of Neuroradiology

4. Anterior-posterior length discrepancy of the spinal column in adolescent idiopathic scoliosis - a 3d CT study. (Abstract)

, and which tissues (bone, disc, intervertebral soft tissue) are involved.The present study aimed to compare the discrepancy of the anterior-posterior length of the spinal column in the "true" midsagittal plane of each vertebra in patients with idiopathic scoliosis versus controls, using three-dimensional computed tomography (CT) scans.This is a cross-sectional study.The sample consisted of computed tomography scans of 80 patients with moderate to severe AIS (Cobb angle: 46°-109°) before scoliosis (...) Anterior-posterior length discrepancy of the spinal column in adolescent idiopathic scoliosis - a 3d CT study. One of the characteristics of reported observations in adolescent idiopathic scoliosis (AIS) is that the thoracic spine is longer anteriorly than posteriorly, more pronounced around the apex than the transitional zones. This reversal of the normal kyphotic anatomy of the thoracic spine is related to questions of etiopathogenesis of AIS. The changes in the anatomy of the anterior column

2018 The Spine Journal

5. Posterior vertebral column resection and intraoperative manual traction to correct severe post-tubercular rigid spinal deformities incurred during childhood: minimum 2-year follow-up. (Abstract)

Posterior vertebral column resection and intraoperative manual traction to correct severe post-tubercular rigid spinal deformities incurred during childhood: minimum 2-year follow-up. To evaluate the clinical and radiographic outcomes of posterior vertebral column resection (PVCR) and intraoperative manual traction to correct severe post-tubercular spinal deformity incurred during childhood.A retrospective review of 11 patients' (4 males and 7 females) charts was performed. Clinical outcome (...) assessment was performed using Oswestry Disability Index and Visual Analog Scale for back pain. Imaging measurements and fusion status were assessed using plain radiography and computed tomography. Intraoperative and postoperative complications were recorded.No perioperative mortality occurred among the patients. The average follow-up was 42.8 ± 13.1 months (range 25-60 months). Kyphosis improved from a preoperative average of 93.4° ± 10.1° to a postoperative average of 18.7° ± 6.3° for a correction

2015 European Spine Journal

6. Evaluation of Agreement Between CT Scan and 3D-DXA Measurements on the Lombar Spine

: 2nd lumbar spine acquisition in same position spine and hip STRATOS DR + 2nd lumbar spine acquisition in same position (with template) Other: DXA + CT Two dual-energy X-ray scans + CT scan Active Comparator: 2nd lumbar spine acquisition spine and hip STRATOS DR + 2nd lumbar spine acquisition (no template) Other: DXA + CT Two dual-energy X-ray scans + CT scan Active Comparator: 2nd hip acquisition in same position spine and hip STRATOS DR + 2nd hip acquisition in same position (with template) Other (...) or beneficiary of a health insurance plan The patient is at least 18 years old The patient has been referred by a doctor for a PET/CT (Positron Emission Tomography-Computed Tomography) scan or a SPECT (Single Photon Emission Computed Tomography) scan in the Nuclear Medicine and Medical Biophysics Department of Nimes hospital Exclusion Criteria: The subject is participating in an interventional study, or is in a period of exclusion determined by a previous study The subject refuses to sign the consent

2018 Clinical Trials

7. Thoracic pedicle classification determined by inner cortical width of pedicles on computed tomography images: its clinical significance for posterior vertebral column resection to treat rigid and severe spinal deformities-a retrospective review of cases. Full Text available with Trip Pro

Thoracic pedicle classification determined by inner cortical width of pedicles on computed tomography images: its clinical significance for posterior vertebral column resection to treat rigid and severe spinal deformities-a retrospective review of cases. Posterior vertebral column resection (PVCR) is an effective alternative for treating rigid and severe spinal deformities. Accurate placement of pedicle screws, especially apically, is crucial. As morphologic evaluations of thoracic pedicles (...) of thoracic pedicles is the sole factor crucial for accurate placement of thoracic pedicle screws. We propose a computed tomography-based classification of the pedicle's inner cortical width: type I thoracic pedicle: absent channel, inner cortical width of 0-1 mm; type II: presence of a channel of which type IIa has an inner cortical width of 1.1-2.0 mm and type IIb a width of ≥2.1 mm. The proposed classification can help surgeons predict whether screws can be inserted into the thoracic pedicle, thus

2014 BMC Musculoskeletal Disorders

8. Osteoporosis and Hip Fracture Risk From Routine Computed Tomography Scans: The Fracture, Osteoporosis, and CT Utilization Study (FOCUS). Full Text available with Trip Pro

Osteoporosis and Hip Fracture Risk From Routine Computed Tomography Scans: The Fracture, Osteoporosis, and CT Utilization Study (FOCUS). Methods now exist for analyzing previously taken clinical computed tomography (CT) scans to measure a dual-energy X-ray absorptiometry (DXA)-equivalent bone mineral density (BMD) at the hip and a finite element analysis-derived femoral strength. We assessed the efficacy of this "biomechanical CT" (BCT) approach for identifying patients at high risk of incident (...) hip fracture in a large clinical setting. Using a case-cohort design sampled from 111,694 women and men aged 65 or older who had a prior hip CT scan, a DXA within 3 years of the CT, and no prior hip fracture, we compared those with subsequent hip fracture (n = 1959) with randomly selected sex-stratified controls (n = 1979) and analyzed their CT scans blinded to all other data. We found that the age-, race-, and body mass index (BMI)-adjusted hazard ratio (HR; per standard deviation) for femoral

2018 Journal of Bone and Mineral Research

9. A High Frequency Spinal Cord Stimulation PET-CT Scan Study

A High Frequency Spinal Cord Stimulation PET-CT Scan Study A High Frequency Spinal Cord Stimulation PET-CT Scan Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. A High Frequency Spinal Cord Stimulation (...) Collaborator: Boston Scientific Corporation Information provided by (Responsible Party): Barts & The London NHS Trust Study Details Study Description Go to Brief Summary: This study aims to investigate the clinical response to Spinal Cord Stimulation frequency parameters: 40Hz, 4000Hz and 10000Hz and explore the brain imaging changes using PET-CT scans. The response to these stimulator settings on health related quality of life will also be measured using validated questionnaires. Condition or disease

2018 Clinical Trials

10. Evaluation of the Thoracic and Lumbar Spine in Blunt Trauma

hip, you are planning to get plain films of the lumbar spine. Again, you wonder if this is sufficient, or if you need to get more advanced imaging (such as a CT) to evaluate for fracture. The first patient gets a “pan-scan” and is found to have isolated facial bone fractures, for which he is evaluated by ENT and eventually discharged home. The second patient is found to have no fractures on plain films, feels much better after ibuprofen, and also goes home. You still have questions about your (...) in both of these patients. For the first patient, you are planning to get a CT of his head, face, and cervical spine, and are considering a CT of the chest, abdomen, and pelvis as well, based purely on the mechanism of injury. You wonder if you even need to consider imaging of the thoracic and lumbar spine, given his lack of physical exam findings, and if so, wonder if you should get CT reconstructions or if plain films would suffice. In the second case, in addition to imaging of the pelvis and left

2019 Washington University Emergency Medicine Journal Club

11. Utilization of CT scanning associated with complex spine surgery. Full Text available with Trip Pro

Utilization of CT scanning associated with complex spine surgery. Due to the risk associated with exposure to ionizing radiation, there is an urgent need to identify areas of CT scanning overutilization. While increased use of diagnostic spinal imaging has been documented, no previous research has estimated the magnitude of follow-up imaging used to evaluate the postoperative spine.This retrospective cohort study quantifies the association between spinal surgery and CT utilization. An insurance (...) database (Humana, Inc.) with ≈ 19 million enrollees was employed, representing 8 consecutive years (2007-2014). Surgical and imaging procedures were captured by anatomic-specific CPT codes. Complex surgeries included all cervical, thoracic and lumbar instrumented spine fusions. Simple surgeries included discectomy and laminectomy. Imaging was restricted to CT and MRI. Postoperative imaging frequency extended to 5-years post-surgery.There were 140,660 complex spinal procedures and 39,943 discectomies

2017 BMC Musculoskeletal Disorders

12. Impact of morphine use in reducing the need for CT scan in patients with cervical spine trauma: a double blinded randomized clinical trial. Full Text available with Trip Pro

Impact of morphine use in reducing the need for CT scan in patients with cervical spine trauma: a double blinded randomized clinical trial. Cervical spine trauma occurs mostly among young males due to falls and car accidents. The CT scan technology is replacing radiography in many medical clinics as it is very capable in detecting subtle cervical spine injuries. However, the use of CT scan for routine screening in patients with cervical spine trauma remains controversial due to its radiation (...) . The pain score of these patients dropped by 52%.The findings of this study suggest that patients with a normal radiography may be discharged with a cervical collar without a need for a CT scan if morphine reduces their pain. This is because the pain in these patients stem from the muscles and non-bony structures in the cervical spine area.The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2013100214872N1.The authors received no financial

2016 Electronic physician Controlled trial quality: uncertain

13. Intraoperative identification of the corticospinal tract and dorsal column of the spinal cord by electrical stimulation. (Abstract)

Intraoperative identification of the corticospinal tract and dorsal column of the spinal cord by electrical stimulation. Anatomical identification of the corticospinal tract (CT) and the dorsal column (DC) of the exposed spinal cord is difficult when anatomical landmarks are distorted by tumour growth. Neurophysiological identification is complicated by the fact that direct stimulation of the DC may result in muscle motor responses due to the centrally activated H-reflex. This study aims (...) to provide a technique for intraoperative neurophysiological differentiation between CT and DC in the exposed spinal cord.Recordings were obtained from 32 consecutive patients undergoing spinal cord tumour surgery from July 2015 to March 2017. A double train stimulation paradigm with an intertrain interval of 60 ms was devised with recording of responses from limb muscles.In non-spastic patients (55% of cohort) an identical second response was noted following the first CT response, but the second

2018 Neurosurgery and Psychiatry

14. What is the clinical and cost effectiveness of diagnostic investigations in adults with suspected subarachnoid haemorrhage, for example a non-contrast CT scan or a lumbar puncture?

What is the clinical and cost effectiveness of diagnostic investigations in adults with suspected subarachnoid haemorrhage, for example a non-contrast CT scan or a lumbar puncture? Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility

2019 PROSPERO

15. Concurrent benign metastasizing leiomyoma in the lung and lumbar spine with elevated standardized uptake value level in positron-emission tomography computed tomography: A case report and literature review. Full Text available with Trip Pro

and bilateral leg pain and paresthesia was admitted to our ward. She has a previous medical history of uterine leiomyomas. Magnetic resonance imaging of the lumbar spine revealed vertebral body osteolytic destruction and soft tissue mass in the L4/5 with a secondary lumbar spinal stenosis. Positron emission tomography computed tomography showed moderately intense accumulation of 18F-fluorodeoxyglucose in the L4/5 mass, as well as multiple nodules with increased metabolic activity in both lungs.Pulmonary (...) Concurrent benign metastasizing leiomyoma in the lung and lumbar spine with elevated standardized uptake value level in positron-emission tomography computed tomography: A case report and literature review. Benign metastasizing leiomyoma (BML) is rare condition involving distant metastases secondary to benign uterine leiomyoma, and it is most commonly found in the lungs. It rarely metastasizes to the spine to cause osteolytic damage and spinal canal compression.A 51-year-old woman with low back

2018 Medicine

16. Validation and accuracy of intraoperative CT scan using the Philips AlluraXper FD20 angiography suite for assessment of spinal instrumentation. (Abstract)

and potentially avoid revision surgery.A total of 36 consecutive patients underwent pedicle screw placement in posterior cervical, thoracic, and lumbosacral spinal fusions. All patients underwent iCT in the Philips AlluraXper FD20 angiography suite in the lumbar spine XperCT mode and postoperative conventional computed tomography (CT) scanning. Primary endpoints included the sensitivity and specificity of iCT in detecting pedicular violation characterized as minor, moderate, or severe when compared (...) Validation and accuracy of intraoperative CT scan using the Philips AlluraXper FD20 angiography suite for assessment of spinal instrumentation. With the concept of the hybrid operating room gaining popularity, the authors adapted a hybrid angiographic suite with intraoperative computed tomography (iCT) to evaluate accuracy of pedicle screw placement in spinal fusion. This retrospective review examines how well iCT detected extrapedicular screw violation, to then allow repositioning

2017 British Journal of Neurosurgery

17. Radionuclide bone scan SPECT-CT: lowering the dose of CT significantly reduces radiation dose without impacting CT image quality Full Text available with Trip Pro

on patient dose as well as the CT image quality with current versus older CT protocols. Ninety nine consecutive patients [n=51 Standard dose 'old' protocol (SDP); n=48 lower dose 'new' protocol (LDP)] with lumbar spine SPECT-CT for bone scan were examined. The main differences between the two protocols were that SDP used 130 kVp tube voltage and reference current-time product of 70 mAs whereas the LDP used 110 kVp and 40 mAs respectively. Various quantitative parameters from the CT images were obtained (...) Radionuclide bone scan SPECT-CT: lowering the dose of CT significantly reduces radiation dose without impacting CT image quality The CT component of SPECT-CT is required for attenuation correction and anatomical localization of the uptake on SPECT but there is no guideline about the optimal CT acquisition parameters. In our department, a standard CT acquisition protocol was changed in 2013 to give lower radiation dose to the patient. In this study, we retrospectively compared the effects

2017 American journal of nuclear medicine and molecular imaging

18. A longitudinal study of disc height narrowing and facet joint osteoarthritis at the thoracic and lumbar spine, evaluated by computed tomography: the framingham study. Full Text available with Trip Pro

A longitudinal study of disc height narrowing and facet joint osteoarthritis at the thoracic and lumbar spine, evaluated by computed tomography: the framingham study. Prevalence and progression of disc height narrowing (DHN) and facet joint osteoarthritis (FJOA) in the thoracic and lumbar regions in non-clinical populations are not well established.The present study aimed to use computed tomography (CT) images to determine the prevalence and progression of DHN and FJOA according to age, sex (...) , and spinal region.This is a 6-year longitudinal study.A total of 1,195 members of the Framingham Study (mean baseline age 61±9 years) were included in the study.We compared the prevalence and progression (new or worsening) of moderate-to-severe DHN and FJOA by age, sex, and spinal region.A musculoskeletal radiologist evaluated DHN and FJOA from T4/T5 to L4/L5 on baseline and follow-up CT images using a semi-quantitative scale: 0=normal, 1=mild, 2=moderate, and 3=severe.One-third or more of women and men

2018 The Spine Journal

19. CT angiography depicted lumbar spinal artery anatomic course: defining a safer zone for lumbar sympathetic and splanchnic blocks. (Abstract)

CT angiography depicted lumbar spinal artery anatomic course: defining a safer zone for lumbar sympathetic and splanchnic blocks. Determining safer techniques for lumbar injections is an important goal in pain medicine. This study aims to characterize the location of the T10-L5 spinal arteries using CT angiogram scans to define a safer approach for sympathetic and splanchnic blocks that minimizes intra-arterial injection.CT angiograms of 68 patients were included this study. The path (...) of the spinal arteries from the aorta origin along the vertebral body to the neural foramina was traced on axial CT images. The sagittal plane of the vertebral body was divided into nine quadrants to map the path of a spinal artery at a vertebral level. At a given vertebral level and laterality, the presence of an artery as well as the quadrants the artery traveled in along its path were recorded.At the anterior vertebral body, >90% of the spinal arteries were observed either at or below the pedicle level

2019 Regional Anesthesia and Pain Medicine

20. Prevalence, Concomitance, and Distribution of Ossification of the Spinal Ligaments: Results of Whole Spine CT Scans in 1500 Japanese Patients. (Abstract)

Prevalence, Concomitance, and Distribution of Ossification of the Spinal Ligaments: Results of Whole Spine CT Scans in 1500 Japanese Patients. Cross-sectional study.To investigate the prevalence, concomitance, and distribution of various types of ossification of the spinal ligaments in healthy subjects using computed tomography (CT).CT has better diagnostic accuracy for ossification of the spinal ligaments compared to plain radiography. Currently there is no study that examines the prevalence (...) of ossification of the spinal ligaments using whole spine CT scans.One thousand five hundred Japanese patients (888 men and 612 women) who underwent positron emission tomography and CT (PETCT) in a private health check center between 2006 and 2013 were included. This PETCT was performed on self-paying participants as a preventive cancer screen. Existence of ossification of the posterior longitudinal ligament (OPLL), ligamentum flavum (OLF), anterior longitudinal ligament (OALL), diffuse idiopathic skeletal

2016 Spine

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