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  • 1
    ISSN: 1279-8517
    Keywords: Cervical spine Discectomy Anterior approach Fusion Anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Twenty adult cadaveric cervical spines were sectioned longitudinally through the midline to display longitudinal sections of the vertebral bodies and disc spaces from C3 to T1. Computer-assisted anatomic images were obtained for measurements of the disc spaces and vertebral bodies. Anteroposterior (AP) depth gradually increased from 16.56 ± 2.21 mm at C3 to 19.32 ± 2.30 mm at C7. Greater values of AP depth at the inferior endplate were found at C5 (20.75 ± 2.87 mm) and C6 (20.56 ± 2.31 mm) compared with the values at C3 (18.26 ± 1.82 mm), C4 (19.27 ± 2.88 mm) and C7 (19.21 ± 3.22 mm). The AP depth at the superior endplate was greater than that at the inferior endplate. The height of the disc space was found to be lowest at the posterior disc space from C2-3 to C7-T1 (2.95 ± 0.86 mm at C2-3, 2.78 ± 0.93 mm at C3-4, 2.45 ± 0.79 mm at C4-5, 2.92 ± 0.64 mm at C5-6, 2.46 ± 0.59 mm at C6-7, 2.93 ± 1.05 mm at C7-T1), when compared to the height of the disc space at the anterior disc space from C2-3 to C7-T1 (4.07 ± 0.85 mm at C2-3, 4.34 ± 1.18 mm at C3-4, 3.95 ± 1.37 mm at C4-5, 3.55 ± 1.37 mm at C5-6, 3.55 ± 0.76 mm at C6-7, 3.67 ± 1.17 mm at C7-T1). The mid-axis of the disc space was situated at approximately 3 mm above the anterior midpoint of the annulus fibrosus at the level of the lower cervical spine. To reach the posterior portion of the disc space from the anterior midpoint of the annulus fibrosus, a 5° cephalad angulation of the drill relative to the mid-axis of the disc space is necessary. All these original data from cadavers may be helpful during anterior approach for discectomy, vertebrectomy and anterior screw-plate placement.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 19 (1997), S. 353-357 
    ISSN: 1279-8517
    Keywords: Sacrum ; Anatomy ; Osteosynthesis ; Screwing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les mesures ont été réalisées directement sur 20 sacrums de cadavres et à partir d'images scannérisées à partir de coupes transversales. Ces mesures intéressaient les paramètres du corps vertébral, de la partie latérale du sacrum, et du canal sacral à hauteur de la deuxième vertèbre sacrale (S2). Nous avons également mesuré la longueur du trajet de la vis et l'angle optimal de son insertion pour une fixation interne par voie postérieure. Les valeurs moyennes étaient les suivantes : hauteur 25,0 mm, diamètre sagittal 13,5 mm, épaisseur 29,4 mm, et largeur 83,0 mm. Les valeurs moyennes intéressant le canal sacral en S2 étaient les suivantes : diamètre sagittal médian 10,3 mm, diamètre transversal maximum 23,1 mm, surface 162,4 mm2. La longueur moyenne de la vis pédiculaire de S2 était de 25,2 mm et sa direction optimale était oblique en avant et médialement de 30,0° par rapport au plan sagittal. La longueur moyenne de la vis alaire insérée dans la partie latérale du sacrum en S2 était de 32,8 mm et sa direction optimale était oblique en avant et latéralement de 22,0°. La présente étude fournit des données anatomiques quantitatives concernant la deuxième vertèbre sacrale. En comparaison avec les données rapportées dans notre précédent travail, tous les paramètres montrent que S2 est plus petite que S1. Si l'on veut tenter la fixation de la vis dans la partie latérale de S2, la traversée de la corticale antérieure peut léser les vaisseaux iliaques ou le tronc lombo-sacral. C'est pourquoi la compréhension de l'anatomie particulière de S2 est indispensable.
    Notes: Summary Direct measurements and measurements from images of axial cross-sections on 20 cadaveric sacra that had been scanned on computer were used in this study. The measurements, including parameters from the vertebral body, lateral mass and spinal canal of the second sacral vertebra (S2) were performed. The length of the screw path and the optimal angulation of the screw placement for dorsal sacral internal fixation were also included. The mean values of height, anteroposterior diameter, width and breadth of the S2 were 25.0 mm, 13.5 mm, 29.4 mm and 83.0 mm, respectively. The mean values of the mid-sagittal diameter, maximum transverse diameter and area of the S2 spinal canal were 10.3 mm, 23.1 mm and 162.4 mm2, respectively. The mean transpedicular screw length of the S2 and optimal medial angle were 25.2 mm and 30.0°, respectively. The mean lateral mass screw length of the S2 and optimal lateral angle were 32.8 mm and 22.0°, respectively. The present study provides quantitative anatomic data of the second sacral vertebra. All parameters indicate that, compared with our previous study, S2 is smaller than S1. When S2 lateral mass screw fixation is intended, anchoring the anterior cortex may violate the iliac vessels or lumbosacral trunk; therefore, understanding the unique anatomy of the S2 is imperative.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 21 (1999), S. 305-307 
    ISSN: 1279-8517
    Keywords: Sacroiliac joint ; Disruption ; Reduction ; Anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le but de cette étude anatomique est de décrire une voie d'abord originale permettant de contrôler directement la réduction d'une luxation de l'articulation sacro-ilaque (LSI), et de guider la mise en place de vis sacroilaques. La réduction d'une LSI est habituellement controlée par rapport à l'aspect du sacrum et de l'ilium du coté opposé au niveau du bord postérieur de la grande échancrure sciatique, mais il existe un manque de données sur le controle de la réduction d'une LSI au niveau de la partie postéro-supérieure de l'articulation sacro-iliaque. Dix cadavres ont été disséqués afin de définir la possibilité de contrôler la réduction d'une LSI au niveau du bord postéro-sup'erieur de l'articulation sacro-iliaque par une voie d'abord postérieure passant immédiatement en dehors de la masse musculaire sacro-lombaire et du cinquième processus transverse lombaire. Les résultats montrent que la partie postéro-supérieure de l'articulation sacro-iliaque et l'aile du sacrum peuvent être directement palpés ou visualisés. Cet abord permet un meilleur contrôle de la réduction d'une LSI et facilite la mise en place de vis sacro-iliaques.
    Notes: Summary This anatomic study was undertaken to describe a new posterior approach enabling direct inspection of reduction of sacroiliac joint disruption (SIJD), and guidance of iliosacral screw placement. The reduction of SIJD is usually monitored by inspection of the opposing sacrum and ilium at the posterior margin of the greater sciatic notch and there is a relative lack of information concerning inspection of reduction of SIJD from the posterosuperior aspect of the sacroiliac joint surface. Ten cadavers were dissected to determine the possibility of inspecting reduction of SIJD from the posterosuperior aspect of the sacroiliac joint by means of a posterior approach which passed immediately lateral to the deep back muscles and the fifth lumbar transverse process. The results indicated that the posterosuperior aspect of the sacroiliac joint surface and sacral ala can be directly palpated or visualised. This approach facilitates improved access for inspection of reduction of SIJD and guidance of iliosacral screw placement.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1279-8517
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1279-8517
    Keywords: Cervical spine ; Discectomy ; Anterior approach ; Fusion ; Anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé 20 colonnes cervicales issues de cadavres d'adultes ont été sectionnées longitudinalement sur la ligne médiane pour fournir des coupes longitudinales des corps vertébraux et des disques intervertébraux de C3 à T1. Les images anatomiques obtenues ont été traitées à l'aide d'un ordinateur pour fournir des mesures des disques intervertébraux et des corps vertébraux. L'épaisseur antéropostérieure (AP) augmentait progressivement de 16,56±2,21 mm en C3 à 19,32±2,30 mm en C7. Les valeurs les plus importantes de l'épaisseur AP au plateau vertébral inférieur ont été relevées en C5 (20,75±2,87 mm) et C6 (20,56±2,31 mm) alors qu'elles étaient plus faibles en C3 (18,26±1,82 mm), C4 (19,27±2,88 mm), et C7 (19,21±3,22 mm). L'épaisseur AP mesurée au plateau vertébral supérieur était plus importante que celle mesurée au plateau inférieur. La hauteur du disque intervertébral était moins élevée à la partie postérieure des disques intervertébraux de C2–C3 à C7-T1 (2,95±0,86 mm en C2–C3, 2,78±0,93 mm en C3–C4, 2,45±0,79 mm en C4–C5, 2,92±0,64 mm en C5–C6, 2,46±0,59 mm en C6–C7, et 2,93±1,05 mm en C7-T1) en comparaison avec celles relevées à la partie antérieure de l'espace de C2–C3 à C7-T1 (4,07±0,85 mm en C2–C3, 4,34±1,18 mm en C3–C4, 3,95±1,37 mm en C4–C5, 3,55±1,37 mm en C5–C6, 3,55±0,76 mm en C6–C7, et 3,67±1,19 mm en C7-T1). L'axe moyen du disque intervertébral était situé environ 3 mm audessus du point moyen antérieur de l'annulus fibrosus au niveau de la partie inférieure de la colonne cervicale. Pour atteindre la partie postérieure de l'espace intervertébral, à partir du point moyen antérieur de l'annulus fibrosus, il faut donner à la mèche une angulation de 5° vers la tête par rapport à l'axe moyen du disque intervertébral. Toutes ces données cadavériques originales peuvent rendre service au cours des abords antérieurs pour discectomie, vertébrectomie, et mise en place de plaque et de vis.
    Notes: Summary Twenty adult cadaveric cervical spines were sectioned longitudinally through the midline to display longitudinal sections of the vertebral bodies and disc spaces from C3 to T1. Computer-assisted anatomic images were obtained for measurements of the disc spaces and vertebral bodies. Anteroposterior (AP) depth gradually increased from 16.56±2.21 mm at C3 to 19.32±2.30 mm at C7. Greater values of AP depth at the inferior endplate were found at C5 (20.75±2.87 mm) and C6 (20.56±2.31 mm) compared with the values at C3 (18.26±1.82 mm), C4 (19.27±2.88 mm) and C7 (19.21±3.22 mm). The AP depth at the superior endplate was greater than that at the inferior endplate. The height of the disc space was found to be lowest at the posterior disc space from C2–3 to C7-T1 (2.95±0.86 mm at C2–3, 2.78±0.93 mm at C3–4, 2.45±0.79 mm at C4–5, 2.92±0.64 mm at C5–6, 2.46±0.59 mm at C6–7, 2.93±1.05 mm at C7-T1), when compared to the height of the disc space at the anterior disc space from C2–3 to C7-T1 (4.07±0.85 mm at C2–3, 4.34±1.18 mm at C3–4, 3.95±1.37 mm at C4–5, 3.55±1.37 mm at C5–6, 3.55±0.76 mm at C6–7, 3.67±1.17 mm at C7-T1). The mid-axis of the disc space was situated at approximately 3 mm above the anterior midpoint of the annulus fibrosus at the level of the lower cervical spine. To reach the posterior portion of the disc space from the anterior midpoint of the annulus fibrosus, a 5° cephalad angulation of the drill relative to the midaxis of the disc space is necessary. All these original data from cadavers may be helpful during anterior approach for discectomy, vertebrectomy and anterior screw-plate placement.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 21 (2000), S. 305-307 
    ISSN: 1279-8517
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This anatomic study was undertaken to describe a new posterior approach enabling direct inspection of reduction of sacroiliac joint disruption (SIJD), and guidance of iliosacral screw placement. The reduction of SIJD is usually monitored by inspection of the opposing sacrum and ilium at the posterior margin of the greater sciatic notch and there is a relative lack of information concerning inspection of reduction of SIJD from the posterosuperior aspect of the sacroiliac joint surface. Ten cadavers were dissected to determine the possibility of inspecting reduction of SIJD from the posterosuperior aspect of the sacroiliac joint by means of a posterior approach which passed immediately lateral to the deep back muscles and the fifth lumbar transverse process. The results indicated that the posterosuperior aspect of the sacroiliac joint surface and sacral ala can be directly palpated or visualised. This approach facilitates improved access for inspection of reduction of SIJD and guidance of iliosacral screw placement.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 19 (1998), S. 353-357 
    ISSN: 1279-8517
    Keywords: Sacrum ; Anatomy ; Osteosynthesis ; Screwing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Direct measurements and measurements from images of axial cross-sections on 20 cadaveric sacra that had been scanned on computer were used in this study. The measurements, including parameters from the vertebral body, lateral mass and spinal canal of the second sacral vertebra (S2) were performed. The length of the screw path and the optimal angulation of the screw placement for dorsal sacral internal fixation were also included. The mean values of height, anteroposterior diameter, width and breadth of the S2 were 25.0 mm, 13.5 mm, 29.4 mm and 83.0 mm, respectively. The mean values of the mid-sagittal diameter, maximum transverse diameter and area of the S2 spinal canal were 10.3 mm, 23.1 mm and 162.4 mm2, respectively. The mean transpedicular screw length of the S2 and optimal medial angle were 25.2 mm and 30.0f, respectively. The mean lateral mass screw length of the S2 and optimal lateral angle were 32.8 mm and 22.0f, respectively. The present study provides quantitative anatomic data of the second sacral vertebra. All parameters indicate that, compared with our previous study, S2 is smaller than S1. When S2 lateral mass screw fixation is intended, anchoring the anterior cortex may violate the iliac vessels or lumbosacral trunk; therefore, understanding the unique anatomy of the S2 is imperative.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 249-252 
    ISSN: 1279-8517
    Keywords: Cervical spine ; Uncinate process ; Radiculopathy ; Decompression ; Anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Morphometric evaluation of 54 dry cervical spines from C3 to C7 (a total of 270 cervical vertebrae) was performed to determine the bony boundaries of the uncinate process for resection of the uncinate process for access to posterolateral osteophytes or herniated disks at the time of anterior cervical diskectomy. The uncinate processes were significantly higher (p 〈 0.01) at the C4 - C6 levels (5.8 ± 1.1 mm to 6.1 ± 1.3 mm) than at the C3 or C7 levels. The distance between the medial and lateral margins of the base of the uncinate process was significantly smaller (p 〈 0.01) at the C3 level (4.9 ± 0.7 mm) than at the C7 level (6.3 ± 0.7 mm). The anteroposterior diameter of the medial margin of the uncinate process decreased gradually from the C5 (12.5 ± 1.5 mm) to C7 levels (11.6 ± 1.3 mm) (p 〈 0.05). The inter-uncinate distance widened from the C3 (19.2 ± 1.5 mm) to the C7 (24.6 ± 2.1 mm) levels (p 〈 0.01). The mid-anteroposterior diameter of vertebral body increased gradually from the C3 (14.7 ± 1.1 mm) to the C7 levels (16.1 ± 1.5 mm) (p 〈 0.01). The width of the vertebra increased gradually from C3 to C7 (from 19.2 ± 1.8 mm at C3 to 25.6 ± 2.0 mm at C7) (p 〈 0.01). Knowledge of all the aforementioned data may be helpful during anterolateral cervical uncosectomy or uncoforaminotomy.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1279-8517
    Keywords: Anterior tibial artery ; Safe zone ; Projection ; Quantitative anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The anterior tibial artery (ATA) is at risk of injury during high tibial osteotomy, Ilizarov wire placement, pin placement in external fixation, or proximal locking screw insertion, as the artery is not visualized intraoperatively. The ATA is anchored to the oval foramen of the interosseous membrane on the proximal tibia by the deep fascia and recurrent genicular vascular branches. Segment 1 (from the bifurcation of the popliteal artery to the level of the interosseous foramen) and the proximal part of segment 2 (from the interosseous foramen to the level where the artery crosses the anterior border of the tibia) may be damaged when pin, wire or screw placement is directed posterolaterally at that level. Distally, a straight mediolateral pin or Ilizarov wires may lacerate the artery. Segment 2 of the ATA descends against the interosseous membrane in its proximal part, which is projected on the posterior third of the tibia relative to the sagittal plane; in its middle part, it runs close to the lateral cortex of the tibia, it is projected on the middle third of the tibia; in its distal part it runs gradually towards the anterior third of the tibia and contacts with the anterior third of the tibial cortical surface. This information may help reduce risk of injury to the ATA during high tibial osteotomy, external fixation and pin placement or insertion of locking screws.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 249-252 
    ISSN: 1279-8517
    Keywords: Cervical spine ; Uncinate process ; Radiculopathy ; Decompression ; Anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Nous avons réalisé l'évaluation morphométrique de 54 colonnes cervicales sèches de C3 à C7 (soit un total de 270 vertèbres cervicales) pour déterminer les limites osseuses du processus unciné, avec application à sa résection pour accéder aux ostéophytes postéro-latéraux ou à une hernie discale au cours d'une discectomie cervicale antérieure. Les processus unciné étaient significativement plus hauts (p〈0,01) aux niveaux C4–C6 (de 5,8 ± 1,1 mm, à 6,1 ± 1,3 mm) qu'aux niveaux C3 ou C7. La distance séparant les bords médial et latéral de la base du processus unciné était significativement plus petite (p〈0,01) au niveau C3 (4,9 ± 0,7 mm) qu'au niveau C7 (6,3 ± 0,7 mm). Le diamètre sagittal du bord médial du processus unciné diminuait graduellement du niveau C5 (12,5 ± 1,5 mm) au niveau C7 (11,6 ± 1,3 mm) (p〈0,05). La distance séparant les processus uncinés augmentait du niveau C3 (19,2 ± 1,5 mm) au niveau C7 (24,6 ± 2,1 mm) (p〈0,01). Le diamètre sagittal médian du corps vertébral augmentait graduellement du niveau C3 (14,7 ± 1,1 mm) au niveau C7 (16,1 ± 1,5 mm) (p〈0,01). La largeur de la vertèbre augmentait graduellement du niveau C3 (19,2 ± 1,8 mm) au niveau C7 (25,6 ± 2,0 mm) (p〈0,01). Les renseignements ainsi obtenus peuvent être utiles au cours des uncusectomies et des uncusoforaminotomies cervicales antéro-latérales.
    Notes: Summary Morphometric evaluation of 54 dry cervical spines from C3 to C7 (a total of 270 cervical vertebrae) was performed to determine the bony boundaries of the uncinate process for resection of the uncinate process for access to posterolateral osteophytes or herniated disks at the time of anterior cervical diskectomy. The uncinate processes were significantly higher (p〈0.01) at the C4 – C6 levels (5.8 ± 1.1 mm to 6.1 ± 1.3 mm) than at the C3 or C7 levels. The distance between the medial and lateral margins of the base of the uncinate process was significantly smaller (p〈0.01) at the C3 level (4.9 ± 0.7 mm) than at the C7 level (6.3 ± 0.7 mm). The anteroposterior diameter of the medial margin of the uncinate process decreased gradually from the C5 (12.5 ± 1.5 mm) to C7 levels (11.6 ± 1.3 mm) (p〈0.05). The interuncinate distance widened from the C3 (19.2 ± 1.5 mm) to the C7 (24.6 ± 2.1 mm) levels (p〈0.01). The mid-anteroposterior diameter of vertebral body increased gradually from the C3 (14.7 ± 1.1 mm) to the C7 levels (16.1 ± 1.5 mm) (p〈0.01). The width of the vertebra increased gradually from C3 to C7 (from 19.2 ± 1.8 mm at C3 to 25.6 ± 2.0 mm at C7) (p〈0.01). Knowledge of all the aforementioned data may be helpful during anterolateral cervical uncosectomy or uncoforaminotomy.
    Type of Medium: Electronic Resource
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