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Thoracic Spine Anatomy

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21. Cervical Spine Anatomy

Anatomy Aka: Cervical Spine Anatomy , C-Spine Anatomy , Cervical Vertebrae , Cervical Spine II. Anatomy: Seven Cervical Vertebrae Level C1: Atlas Level C2: Axis with Dens and Odontoid process Level C7: prominens Spinous process long and prominent C8 cervical nerve root exits below C7 III. Anatomy: General Cervical spinal nerves C1-C7 exit about their corresponding e In transitioning to , C8 exits below the C7 , and above T1 In contrast, all thoracic and lumbar spinal nerves exit below (...) 122494005 , 84667006 LNC LP30301-3, MTHU012095 English Cervical spine , Cx - Cervical spine , Cervical vertebral column , Cervical Spine , C Spine , Spine.cervical , cervical vertebral column , cervical spines , cervical vertebrae , cervical spine , cervical spinal column , cervical vertebras , Structure of cervical vertebral column , Cervical spine structure , Structure of cervical vertebral column (body structure) , Cervical spine structure (body structure) , Cervical spinal column Spanish columna

2018 FP Notebook

22. Consensus Practice Guidelines on Interventions for Lumbar Facet Joint Pain

confirmation, which is potentially problematic at upper lumbar vertebrae. For example, a study performed in the thoracic spine found that misidentifica- tion of the targeted spinal level occurred between 16% and 43% of the time depending on the scanning technique, with IA at 6 weeks and 3 months Differences favoring MBB non- significant at 6 months. Cohen et al 134 Case- control 511 who under MBB (n=212), IA (n=212) or MBB and IA (n=87) before RFA MBB with 0.5–0.75 mL LA or IA with 0.5–1 mL LA+steroid MBB (...) of the seven Revel’s criteria (above) including pain reduction by recumbency resulted in 92% sensitivity and 80% specificity. Manchikanti et al 50 Prospective n=120 =75% pain reduction MBB (double comparative diagnostic blocks) The prevalence of clinical findings (pain better by sitting/lying, pain worsened by sitting/standing/walking/coughing/lumbar spine range of motion, positive straight leg raising test and pain referral pattern) were similar between positive and negative block groups. Back pain

2020 American Academy of Pain Medicine

23. Consensus Practice Guidelines on Interventions for Lumbar Facet Joint Pain from a Multispecialty, International Working Group Full Text available with Trip Pro

spread was noted in 70% of injections. In addition, a case report in an active duty service member described a spinal headache requiring an epidural blood patch following a blind lumbar facet block. Guidelines and insurance coverage The SIS guidelines state ‘fluoroscopy is mandatory for the conduct of lumbar medial branch blocks’ as it provides an overview of the bony anatomy as well as the ability to confirm contrast spread. For MBB, the nerve is not directly visible with fluoroscopy, but its (...) that in current practice, CT should not be used for thermocoagulation of the lumbar medial branches. Use of ultrasound in the lumbar spine The use of ultrasound may provide an alternate imaging modality for performance of MBB and IA injections. This modality has widespread acceptance in regional anesthesia and can visualize soft tissue anatomy, neural structures and vascular supply. In addition, ultrasound is portable, can be used in pregnancy and does not require use of protective garments. However

2020 American Society of Regional Anesthesia and Pain Medicine

24. Thoracic Outlet Syndrome.

Thoracic Outlet Syndrome. Date of origin: 2014 ACR Appropriateness Criteria ® 1 Imaging in the Diagnosis of Thoracic Outlet Syndrome American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Imaging in the Diagnosis of Thoracic Outlet Syndrome Radiologic Procedure Rating Comments RRL* X-ray chest 8 ? MRA chest without and with IV contrast 8 O CTA chest with IV contrast 7 ??? MRI chest without IV contrast 7 O US duplex Doppler subclavian artery and vein 6 O Digital (...) subtraction angiography upper extremity 5 ? CT chest without IV contrast 3 ??? MRA chest without IV contrast 2 O Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Imaging in the Diagnosis of Thoracic Outlet Syndrome IMAGING IN THE DIAGNOSIS OF THORACIC OUTLET SYNDROME Expert Panels on Vascular Imaging, Neurologic Imaging and Thoracic Imaging: John M. Moriarty, MB, BCh 1 ; Dennis F. Bandyk, MD 2

2019 American College of Radiology

25. ACR–ASNR–SCBT-MR Practice Parameter for the Performance of Magnetic Resonance Imaging (MRI) of the Adult Spine

, including abscess 4. Vascular disorders a. Spinal vascular malformations and/or the cause of occult subarachnoid hemorrhage b. Spinal cord infarction c. Extraspinal vascular malformations and neoplasms PRACTICE PARAMETER 3 MRI Adult Spine 5. Degenerative conditions a. Degenerative disc disease and its sequelae in the lumbar, thoracic, and cervical spine, including myelopathy b. Disc herniation and radiculopathy c. Neurodegenerative disorders, such as subacute combined degeneration, spinal muscular (...) atrophy, amyotrophic lateral sclerosis d. Spinal Stenosis 6. Trauma Nature and extent of injury to spinal cord, vertebral column, ribs, and skull base; ligaments, thecal sac, and paraspinal soft tissues following trauma (CT is considered the Gold Standard primary tool for the initial evaluation of the traumatized spine, with MRI often performed to provide complementary data, particularly when the patients' clinical findings are discrepant with the initial CT findings.) 7. Neoplastic abnormalities

2019 American Society of Neuroradiology

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

. [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 (...) utility. If there is a clinical concern for spinal injury, MRI (by itself or in conjunction with clinical observation) should be considered in pediatric patients as an alternative or complement to a targeted CT of the area of concern. 3. Degenerative conditions and osteoarthritis evaluation. CT is often used to study the spine for conditions such as lumbar stenosis or in evaluating disc degeneration and is the primary evaluation technique when MRI is contraindicated (eg, the presence of cardiac

2019 American Society of Neuroradiology

27. Spinal Cord Anatomy

Spinal Cord Anatomy Spinal Cord Anatomy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Spinal Cord Anatomy Spinal Cord Anatomy Aka (...) : Spinal Cord Anatomy , Spinocerebellar Tract , Corticospinal tract , Spinothalamic Tract , Fasciculus Gracilis , Fasciculus Cuneatus , Nucleus Gracilis , Nucleus Cuneatus , Dorsal Propriospinal Tract , Posterior Column , Spinocervicothalamic Tract , Internal Arcuate Tract , Medial Lemniscus II. Components: Spinal Cord Levels ral Total spinal nerves: 31 pairs Spinal cord ends at L2 Spinal nerves L2 to S5 descend as individual "horse hairs" (cauda equina) Nerves exit at their respective l levels

2018 FP Notebook

28. Lumbar and thoracic perforators: vascular anatomy and clinical implications. (Abstract)

Lumbar and thoracic perforators: vascular anatomy and clinical implications. Pedicled perforator flaps in the thoracic and lumbar regions allow reconstruction of the posterior trunk. They enable reconstruction of various local defects without microvascular anastomoses and with minimal donor-site morbidity and excellent cosmesis. The authors examined the locations of perforators in the lumbar and thoracic regions.Ten cadaver hemithoraces and lumbar regions were freshly harvested and dissected (...) . Intraarterial injections were performed with colored latex, followed by dissection in the suprafascial plane. Perforators with a diameter larger than 0.5 cm were located and measured from the midline and from C7 (thoracic) and coccygeal (lumbar) reference points. The most dominant perforators were injected with radiopaque dye and scanned with high-resolution computed tomography. The patterns were analyzed by the quadrat counting test (based on chi-square statistics) for the null hypothesis of complete

2014 Plastic and reconstructive surgery

29. Society of Interventional Radiology Reporting Standards for Thoracic Central Vein Obstruction

of thoracic central veins. THORACIC CENTRAL VEIN ANATOMY The Normal Thoracic Central Veins Thoracic veins can be categorized as central (systemic veins), somatic (azygos/hemiazygos, super?cial, body wall veins), or visceral (pulmonary veins, coronary sinus). This document will discuss obstruction of the thoracic central veins, which can be broadly considered a continuation of the deep veins of the head, neck, and upper extremities. However, before addressing the thoracic central veins, it is worth noting (...) method was used because most work is retrospective, without consistent de?nitions or endpoints. Additionally, anatomy and terminology of TCVO vary. The axillary vein is sometimes considered a thoracic central vein (45), and the brachioce- phalic vein (BCV) has been incorrectly termed the innominate vein (45,53). Therefore, the foremost purpose of these reporting standards is to provide a simple, consistent, and useful way for clinicians and researchers to describe TCVO across all disciplines

2018 Society of Interventional Radiology

30. Incidence and Clinical Significance of Vascular Encroachment Resulting from Free Hand Placement of Pedicle Screws in the Thoracic and Lumbar Spine: Analysis of 6,816 Consecutive Screws. (Abstract)

Incidence and Clinical Significance of Vascular Encroachment Resulting from Free Hand Placement of Pedicle Screws in the Thoracic and Lumbar Spine: Analysis of 6,816 Consecutive Screws. Retrospective case series.Evaluate the incidence and clinical significance of vascular encroachment resulting from freehand placement of pedicle screws in the thoracic and lumbosacral spine.Pedicle screws are routinely used to effectively stabilize all 3 columns of the spine but can be technically demanding (...) to place in the setting of variable anatomy. There is a paucity of data regarding iatrogenic major vascular injuries during posterior instrumentation procedures.We retrospectively reviewed the records of all patients undergoing freehand pedicle screw placement without image guidance in the thoracic or lumbar spine during a 7-year period. The incidence and extent of vascular encroachment by a pedicle screw was determined by review of routine postoperative computed tomographic scans obtained within 24

2014 Spine

31. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

in the upper thoracic spine, 4.1 mm at the T11–T12, and 4 to 7 mm in the lumbar regions. The epidural space has extensive thin-walled, valveless venous plexi (plexus venous vertebralis interior, anterior, and posterior), which are vulnerable to damage during needle placement and advancement of spinal cord stimulator leads and epidural and intrathecal catheters. These epidural veins are mainly found in anterior and lateral aspects of the epidural space. Furthermore, the fragility of these vessels increases (...) -thirds of the participants (67%) had separate protocols regarding aspirin (acetylsalicylic acid [ASA]) or nonsteroidal anti-inflammatory drugs (NSAIDs). Moreover, 55% stopped ASA before spinal cord stimulation (SCS) trials and implants, and 32% stopped ASA before epidural steroid injections (ESIs). However, 17% admitted that they used different protocols for cervical spine injections as compared with lumbar spine injections. Most did not express familiarity with selective serotonin reuptake

2018 American Society of Regional Anesthesia and Pain Medicine

32. Chest Neurologic Anatomy

structure (C0460005) Definition (FMA) Subdivision of body proper, which consists of a maximal set of diverse subclasses of organ and organ part spatially associated with the ribcage, thoracic and lumbar vertebral column, sacrum and coccyx, it is partially surrounded by skin of trunk. Examples: There is only one trunk. Definition (MSH) The central part of the body to which the neck and limbs are attached. Definition (MSHCZE) Střední část těla, ke které je připojen krk a končetiny. Definition (UWDA) Body (...) part, which consists of a maximal set of diverse subclasses of organ and organ part spatially associated with the thoracic and lumbar vertebral column, sacrum and coccyx, it is partially surrounded by skin of trunk. Examples: There is only one trunk. Definition (NCI_CDISC) The body excluding the head and neck and limbs. (NCI) Definition (NCI) The body excluding the head and neck and limbs. Concepts Body Location or Region ( T029 ) MSH SnomedCT 41253007 , 22943007 LNC LP7660-6, MTHU002839 English

2018 FP Notebook

33. Thoracic Aorta Interventional Planning and Follow-up

Thoracic Aorta Interventional Planning and Follow-up New 2017 ACR Appropriateness Criteria ® 1 Thoracic Aorta Interventional Planning and Follow-Up American College of Radiology ACR Appropriateness Criteria ® Thoracic Aorta Interventional Planning and Follow-Up Variant 1: Planning for pre-thoracic endovascular repair (TEVAR) of thoracic aorta disease. Radiologic Procedure Rating Comments RRL* CTA chest abdomen pelvis with IV contrast 9 See references [10,11,24-26,38-54,56-58]. ????? CTA chest (...) with IV contrast 7 This procedure is appropriate if pathology is contained to the thoracic aorta. See references [10,11,24-26,38-54,56-58]. ??? MRA chest abdomen pelvis with IV contrast 7 See references [10,36,39,60,61]. O MRA chest with IV contrast 7 This procedure is appropriate if pathology is contained to the thoracic aorta. See references [10,36,39,60,61]. O MRA chest abdomen pelvis without IV contrast 6 Use this procedure if contrast is contraindicated. See references [36,39,60]. O MRA chest

2017 American College of Radiology

34. Analysis of the techniques for thoracic- and lumbar-level localization during posterior spine surgery and the occurrence of wrong-level surgery: results from a national survey. (Abstract)

Analysis of the techniques for thoracic- and lumbar-level localization during posterior spine surgery and the occurrence of wrong-level surgery: results from a national survey. Despite the frequency with which surgeons perform posterior spinal surgery and the precautions against wrong-site surgery, operations on incorrect levels still occur. Wrong-level exposure is documented in 0.32% to 15% of cases. Additionally, there is little consensus as to what is the most accurate method for localizing (...) the correct spinal level.The purpose of this study is to investigate the most commonly used localization methods and their association with wrong-level surgery, to determine the prevalence of wrong-level localization, and to identify circumstances commonly associated with wrong-level surgery, and to offer recommendations that may reduce the incidence of these errors.This was an online survey study that was distributed to North American Spine Society (NASS) members (including both orthopedic surgeons

2013 The Spine Journal

35. Thoracic Spine Anatomy

. Concepts Body Part, Organ, or Organ Component ( T023 ) SnomedCT 122495006 , 35769007 LNC LP30308-8, MTHU012102 English TX - Thoracic spine , Columna vertebralis thoracicus , Thoracic Spine , T Spine , Spine.thoracic , thoracic spine , spine thoracic , Thoracic spine , Thoracic vertebral column , Thoracic spine structure (body structure) , Thoracic spine structure Spanish columna dorsal , columna espinal dorsal , columna espinal torácica , columna torácica , columna vertebral dorsal , columna vertebral (...) Thoracic Spine Anatomy Thoracic Spine Anatomy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Thoracic Spine Anatomy Thoracic Spine

2015 FP Notebook

36. A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression

risk of SCC. In one study, risk of SCC before death was 24%, and 2.37 times greater with a Gleason score = 7 than with a score of 90% of patients, spinal metastases are extradural, most often arising in the vertebral column and then extending into the epidural space. Spinal metastases very rarely involve the intradural and intramedullary regions of the spine. 10 The average time from original diagnosis of cancer to development of spinal metastases has been estimated to be 32 months and the average (...) 48,000 women were diagnosed with breast cancer in 2008 (see Table 2). 4 The European age-standardised (AS) incidence rate FIGURE 1 Spinal cord. Reproduced with permission from CancerHelp UK, the patient information website of Cancer Research UK. URL: http://cancerhelp.cancerresearchuk.org. Cervical Thoracic Lumbar SacralNIHR Journals Library www.journalslibrary.nihr.ac.uk IntrODuctIOn 4 for breast cancer was reported as 124 per 100,000 in the UK in 2008. 3 Using the adjusted for multiple primaries

2013 NIHR HTA programme

37. Comparison of Cervical Spine Anatomy in Calves, Pigs and Humans Full Text available with Trip Pro

Comparison of Cervical Spine Anatomy in Calves, Pigs and Humans Animals are commonly used to model the human spine for in vitro and in vivo experiments. Many studies have investigated similarities and differences between animals and humans in the lumbar and thoracic vertebrae. However, a quantitative anatomic comparison of calf, pig, and human cervical spines has not been reported.To compare fundamental structural similarities and differences in vertebral bodies from the cervical spines (...) of commonly used experimental animal models and humans.Anatomical morphometric analysis was performed on cervical vertebra specimens harvested from humans and two common large animals (i.e., calves and pigs).Multiple morphometric parameters were directly measured from cervical spine specimens of twelve pigs, twelve calves and twelve human adult cadavers. The following anatomical parameters were measured: vertebral body width (VBW), vertebral body depth (VBD), vertebral body height (VBH), spinal canal

2016 PloS one

38. Lumbar Spine Anatomy

Lumbar Spine Anatomy Lumbar Spine Anatomy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Lumbar Spine Anatomy Lumbar Spine Anatomy (...) Aka: Lumbar Spine Anatomy , L-Spine Anatomy , Lumbar Spine , Lumbosacral Spine II. Anatomy: Nerve Course Disc disease affects nerve exiting one level below Nerve passes over the affected disc Example L4-5 disc tion affects L5 nerve Contrast with III. Anatomy: Components Spinal cord terminates at L1-L2 in the adult Lumbosacral nerve roots comprise cauda equina IV. Images: Bone Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy

2015 FP Notebook

39. Revascularisation of the left subclavian artery for thoracic endovascular aortic repair. (Abstract)

Revascularisation of the left subclavian artery for thoracic endovascular aortic repair. Controversy exists as to whether revascularisation of the left subclavian artery (LSA) confers improved outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR). Even though preemptive revascularisation of the LSA has theoretical advantages, including a reduced risk of ischaemic damage to vital organs, such as the brain and the spinal cord, it is not without risks. Current practice (...) guidelines recommend routine revascularisation of the LSA in patients undergoing elective TEVAR where achievement of a proximal seal necessitates coverage of the LSA, and in patients who have an anatomy that compromises perfusion to critical organs. However, this recommendation was based on very low-quality evidence.To assess the comparative efficacy of routine LSA revascularisation versus either selective or no revascularisation in patients with descending thoracic aortic disease undergoing TEVAR

2016 Cochrane

40. Joint position statement on open and endovascular surgery for thoracic aortic disease

(DTAA) ii. Distal malperfusion iii. Young patients iv. Patients with known connective tissue disorders (Weak Recommendation, Low-Quality Evidence). Values and preferences. Extended distal repair should only be offered if surgical safety is not compromised. Appoo et al. 709 Thoracic Aortic Disease InterventionsTotal Endovascular Arch Repair Although open repair remains the gold standard, several strategies have been developed for a closed-chest approach to aortic arch aneurysms (Supplemental Table S5 (...) with a similar incidence between sexes. 104 The introduction of thoracic endovascular aortic repair (TEVAR) has resulted in increased rates of emergent and elective repair of DTAAs in the United States. 105 This increased uptake has resulted ina decreasein surgical mortalityandshorter hospital stays despite older patients with higher degrees of comorbid- ities. 106 Major complication rates of TEVAR include 5%-6% mortality, 3%-5% stroke, 2%-3% spinal cord ischemia, and 1%-6% retrograde type A dissection. 107

2016 CPG Infobase

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