Biomechanical Study of Patient Positioning

Driscoll, Christopher; Aubin, Carl‐Éric; Canet, Fanny; Horton, William C.; Dansereau, J.

doi:10.1097/bsd.0b013e31820d5804

Cited by 10 publications

(3 citation statements)

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“…LL in the prone position was affected by the hip joint and increased when the hip joint was hyperextended, decreased when the hip joint was hyper exed, and was less affected by the hip joint when the hip joint was within 30° of exion [33,34]. Compared with the standing position, there was no signi cant change in LL in the prone position in this group, probably due to the pelvic cushion causing hip exion within 30°.…”

Section: Discussionmentioning

confidence: 65%

Treatment of late posttraumatic spinal kyphosis with no osteotomy or only posterior column osteotomy based on prone imaging parameters

Cui

Wang

Yang

et al. 2023

Preprint

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Background The current surgical options for late posttraumatic spinal kyphosis are primarily based on standing x-rays. The degree of deformity is reduced in the prone position. This self-correction of the deformity could be achieved without osteotomy or instruments, making large osteotomies no longer necessary. Osteotomy based on prone imaging data for the treatment of late posttraumatic kyphosis has not been reported. We, therefore, aimed to evaluate the clinical efficacy of simple posterior column osteotomy or non-osteotomy based on prone x-rays. Methods From April 2017 to November 2020, we collected preoperative standing, prone, postoperative, and final follow-up imaging data of 18 patients admitted to our hospital for late posttraumatic kyphosis using simple posterior column osteotomy or non-osteotomy. Preoperative prone data of thoracic kyphosis angle (TK), local kyphosis Cobb angle (LKCA), and lumbar lordosis angle (LL), was obtained. Preoperative, immediate postoperative, and final follow-up TK, LKCA, LL, sagittal vertebral axis (SVA), pelvic tilt (PT), and pelvic incidence minus lumbar lordosis angle (PI-LL) data was also obtained on standing x-ray imaging. The operative time, bleeding, and operative complication rate was collected and analyzed. We compared the preoperative, two month postoperative, and final follow-up Oswestry disability index (ODI) and visual analog score (VAS) scores to evaluate the surgical results. Result LKCA and TK significantly reduced from the standing to prone position before surgery. The LKCA, TK, and SVA of immediate postoperative and last follow-up data were statistically different compared with those before surgery; the differences in LL, PT, and PI-LL in the postoperative period and at the last follow-up were not statistically significant compared with those before surgery. All patients were operated upon successfully, with an operative time of 152.7 ± 34.2 min, a bleeding volume of 408.3 ± 135.3 ml, no complications of infection or nerve injury, and a decrease in ODI scores and VAS scores at two months and at the last follow-up (P < 0.05) after surgery. Conclusion Based on prone imaging, simple posterior column osteotomy or non-osteotomy surgery for traumatic kyphosis with good flexibility and no neurological symptoms is safe, with potential reduction in operative time, complications, and bleeding.

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Section: Discussionmentioning

confidence: 65%

Treatment of late posttraumatic spinal kyphosis with no osteotomy or only posterior column osteotomy based on prone imaging parameters

Cui

Wang

Yang

et al. 2023

Preprint

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“…Авторами отмечены явления миопатии и значительное уменьшение волокон II типа в M. gluteus maximus [5,6]. Кроме того, есть ряд исследований, указывающих на тесную связь деформации позвоночника и патологических изменений в области таза, а также влияние мышц тазобедренного суста-a б ва и нижних конечностей на позвоночник [16][17][18][19][20]. Единственная работа по МСКТ ягодичных мышц посвящена изучению их у больных ахондроплазией, имеющих выраженные изменения в позвоночнике и тазобедренных суставах.…”

Section: Discussionunclassified

Multislice Computed Tomography in Diagnosing Changes in the Gluteal Muscles of Patients with Scoliosis at Different Ages and with Different Magnitudes of Deformation Before Treatment

Дьячкова

Зейналов²,

Корабельников

et al. 2020

Vestn. rentgenol. radiol.

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Objective. To study the gluteal muscles in patients with scoliosis of various etiologies using multislice computed tomography (MSCT).Material and methods. MSCT was first used to study the gluteal muscles of 27 patients with idiopathic scoliosis. The patients were examined to study the vertebral column in order to determine a method and tactics for scoliosis treatment. The muscles were additionally examined using workstations and programs for MSCT data processing. In a control group of 18 patients with no clinical manifestations of spinal and hip joint abnormalities or those detected on CT, their gluteal muscles were examined due to their pelvic organ diseases.Results. Patients younger than 18 years of age who had spinal deformations of not more than 60 degrees had muscle changes as moderate hypotrophy, increased density, especially that of the gluteus medius muscle to 62.01 ± 7.20 HU. In patients over 18 years of age, the muscle density decreased at any magnitude of deformation and was the smaller the older patients were. In patients with spinal deformation greater than 90 degrees, the density of the gluteus maximus muscle on the convex side was significantly different from that on the concave side and was less on the concave side (p <0.05) than in those with a deformation of 60–90 degrees.Conclusion. The results showed that in patients with scoliosis, the gluteal muscles were affected not only by the magnitude of deformation, but also by age. In patients over 18 years of age, muscle changes with equal magnitudes of deformation were more pronounced and were manifested by hypotrophy, atrophy, and fatty degeneration.

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“…One area that has not been examined in greater detail is how the head and neck of the animal should be positioned, and how positioning could impact the outcomes and variability in animal SCI models. While head and neck positioning are well-recognized for their significant effects on human spinal cord morphology and spinal cord injury biomechanics ( 12 , 13 ), there is limited exploration of its effects in animal contusion models. In fact, positioning of the head and neck of animals is often under-reported and is far from being standardized in animal models of SCI.…”

Section: Introductionmentioning

confidence: 99%

The biomechanical implications of neck position in cervical contusion animal models of SCI

Obaid,

Morioka,

Sinopoulou

et al. 2023

Front. Neurol.

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Large animal contusion models of spinal cord injury are an essential precursor to developing and evaluating treatment options for human spinal cord injury. Reducing variability in these experiments has been a recent focus as it increases the sensitivity with which treatment effects can be detected while simultaneously decreasing the number of animals required in a study. Here, we conducted a detailed review to explore if head and neck positioning in a cervical contusion model of spinal cord injury could be a factor impacting the biomechanics of a spinal cord injury, and thus, the resulting outcomes. By reviewing existing literature, we found evidence that animal head/neck positioning affects the exposed level of the spinal cord, morphology of the spinal cord, tissue mechanics and as a result the biomechanics of a cervical spinal cord injury. We posited that neck position could be a hidden factor contributing to variability. Our results indicate that neck positioning is an important factor in studying biomechanics, and that reporting these values can improve inter-study consistency and comparability and that further work needs to be done to standardize positioning for cervical spinal cord contusion injury models.

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Biomechanical Study of Patient Positioning

Abstract: Knowledge gained through this study can be used to improve intraoperative control of sagittal curves through lower limb positioning.

Cited by 10 publications

References 0 publications

Treatment of late posttraumatic spinal kyphosis with no osteotomy or only posterior column osteotomy based on prone imaging parameters

Treatment of late posttraumatic spinal kyphosis with no osteotomy or only posterior column osteotomy based on prone imaging parameters

Multislice Computed Tomography in Diagnosing Changes in the Gluteal Muscles of Patients with Scoliosis at Different Ages and with Different Magnitudes of Deformation Before Treatment

The biomechanical implications of neck position in cervical contusion animal models of SCI

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