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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sagittal plane curve characteristics of the thoracolumbar spine were evaluated from 286 lateral chest radiographs comparing the Cobb technique with a computer-aided digitizer. Thoracic kyphosis and curve apex were measured from the T3 to T11 segments, and in 120 cases, the level of the thoracolumbar curve inflexion point was determined. An age-related increase in curve magnitude was similar for both measurements, although computer generated kyphosis angles were generally larger. The apex of thoracic kyphosis was consistently located near T7 for males compared with greater variability with age for females. The thoracolumbar inflexion point shifted caudally with increasing years, being most marked for females. The computer method was more reliable, producing a coefficient of variation of 1.4% on repeated measurement. The ability to describe quantitatively the thoracolumbar curve characteristics, calculate angles between selected segments, determine points of inflexion and maximum curvature, indicates that radiographic evaluation of sagittal spinal curvature is improved with the use of computer-aided measurement.
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PMID:A comparison of radiographic and computer-assisted measurements of thoracic and thoracolumbar sagittal curvature. 232 51

Thoracic spondylotic myelopathies are exceptional, only 29 observations could be found in the literature; we intend to describe three new cases here. The patients, two women and one man, 64, 69 and 72 years old, complained of weakness of the lower limbs, more marked on one side, which had been progressing slowly from several months to eight years. Examination revealed asymmetrical paraparesis with distal sensitivity deficits without thoracic sensory level. In the first case, the myelography remained virtually unchanged in front of T11, T12; in the second and third cases, there was slight extradural compression at T9 and T10 respectively. Magnetic Resonance Imaging (M.R.I.) performed in two patients was evocative of a thoracic disk herniation. A chest CT scan enabled us to establish correct diagnosis: in the three cases irregular hypertrophy of the posterior elements was evident at T11 and T12, T9 and T10, T10 and T11 respectively, with osteophytes originating in the articular process and deeply embedded in the spinal canal. Decompressive laminectomy associated with medial facetectomy resulted in the gradual improvement of walking in all three patients. Myelography and MRI are both useful in demonstrating the level compression, usually situated in the low thoracic spine, however only the CT allows differential diagnosis with other etiologies, especially anterior compression such as disk herniation.
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PMID:[Myelopathies caused by dorsal spinal canal spondylotic stenosis. 3 cases and a review of the literature]. 269 79

A case of spinal dumbbell shaped melanotic schwannoma was reported. A 58-year-old housewife had a 3-months history of progressive gait disturbance. She also complained of mild backache and numbness in both legs. Her family history was not remarkable. When examined on admission, October 10, 1982, mild weakness of both legs with spasticity and sensory impairment below the level of T10 dermatome without sacral sparing were evident. Her deep tendon reflexes were hyperactive on both sides and plantar responses were extensor bilaterally. Sphincteric disturbance was not significant. The function of her cranial nerves was intact. She had neither cutaneous lesions, abdominal mass nor organomegaly. Thoracic plain X-rays revealed erosion of the right side vertebral body and pedicle of the 10th thoracic vertebra. Myelography disclosed a complete block at the same level by an epidural mass. On CT-myelogram, soft tissue density mass compressing the thoracic cord was apparent in the right epidural space of the spinal canal which extended to the paravertebral region through the right intervertebral foramen. Partial destruction of the body and the right side pedicle was easily recognized. Laminectomy from T9 to T11 exposed a large extradural mass which was encapsulated, elastic soft and pigmented in nature. The tumor was dumbbell shaped and extended to the right paravertebral region through the intervertebral foramen. Costotransversectomy was performed to excise the mass entirely. Following the total removal of the tumor, internal fixation was carried out by means of Harrington instrumentation with methylmethacrylate.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Spinal melanotic schwannoma: report of a case]. 306 Jul 51

A 52-year-old male with pulmonary hypertension secondary to partial anomalous pulmonary venous return unassociated with atrial septal defect was given thoracic epidural anaesthesia for elective cholecystectomy. Partial anomalous pulmonary venous return is a rare congenital anomaly characterized by increased pulmonary blood flow which in severe cases results in pulmonary hypertension subjecting the right ventricle to strain. An epidural catheter was placed at the T11-T12 interspace and anaesthesia was established to the T4 dermatomal level with bupivacaine (180 mg) and lidocaine (100 mg). Central venous pressure, pulmonary artery pressure, radial artery pressure, and cardiac output were monitored. There was minimal change in pulmonary arterial pressure, although there was a significant drop in systemic arterial pressure. Thoracic epidural block is recommended for upper abdominal surgery in clinical situations with pulmonary hypertension.
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PMID:Low thoracic epidural anaesthesia for elective cholecystectomy in a patient with congenital heart disease and pulmonary hypertension. 682 89

Four cases of thoracic spondylotic myelopathy are reported, one man and three women, respectively 61, 66, 67 and 76 years old. Clinical presentation was numbness and weakness in the lower limbs in two cases, weakness alone in one and numbness alone in the last one. Diagnosis was settled by both myelography and CT-myelogram in three cases, by both MRI and CT-scan in the other one. The involved thoracic levels were both T9-T10 and T10-T11 for two cases and T11-T12 for the other one. The stenosis was due to hypertrophic ossification of the ligamentum flavum in three cases and to osteophytic changes in one. A laminectomy was performed for each patient and three patients had a significant recovery and the fourth a mild one. Thoracic myelopathy is an uncommon disease which requires a meticulous study of myelogram and now MRI to be recognized and to be cured by laminectomy. As for cervical myelopathy, it results from mechanical and ischemic factors which can lead to a definitive myelomalacia.
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PMID:[Thoracic spondylotic myelopathies. Apropos of 4 new cases]. 908 41

Monitoring the descending neural motor volleys (MEPs), in comparison to muscle action potentials, allows sensitive motor assessment under anesthesia irrespective of the use of muscular blockade and status of skeletal musculature. Ketamine hydrochloride (KH) had preserved muscle MEPs on a pre-established primate model. The present work examines the effect of incremental hypnotic KH dosages thoracic neural on somatosensory (SEP) and MEPs recorded epidurally in response to transcranial magnetic stimulation (TMS). Through a small thoracic T11-T12 laminotomy, an insulated double bipolar electrode was inserted epidurally and cephalad in seven cynomolgus monkeys. Thoracic spinal TMS-MEPs, and SEPs, were tested against graded increase of KH doses (0.01, 0.018, 0.032, 0.056, 0.1, and 0.18 mg kg(-1) min(-1) i.v. infusion). The direct (D-) and indirect (I-) epidural MEP peaks were well-defined under sole KH infusion. The waveforms were consistent at various dosages. At the highest cumulative dose (0.18 mg kg(-1) min(-1), total 6.5 mg kg(-1) over 150 min), I5 was host and I3 and I4 latencies were delayed. The scalp and spinal SEP showed no significant change. Recording of both neural D- and I- MEPs and SEPs is feasible under high sole i.v. KH. It is the first agent to maintain up to four later I1 peaks. The reproducibility of both modalities is unquestionable under KH-based deep anesthesia. This reflects the maintenance of state of neural excitability under KH.
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PMID:High-dose ketamine hydrochloride maintains somatosensory and magnetic motor evoked potentials in primates. 1176 Aug 82

Many Cobb measurements have been reported at various levels for the thoracic kyphosis, but geometric models of the shape of kyphosis are rare. Thoracic vertebral bodies were digitized on 80 normal lateral full-spine radiographs to obtain the mean thoracic kyphosis. Global and segmental angles were determined. Computer iteration processes passed geometric shapes through the posterior body coordinates of the mean thoracic kyphosis to determine the best fit model in the least squares sense. The kyphosis was closely modeled with ellipses. The T1 and T12 areas tended to be flatter in curvature when compared with T2-T11, indicating these are inflection points. Mean global angles were Cobb(T1-T12) = 44.2 degrees, Cobb(T2-T11) = 39.9 degrees, and Cobb(T3-T10) = 33.3 degrees. The T2-T11 kyphotic region was closely modeled with approximately a 70-degree portion of an ellipse, with minor axis to major axis ratios of 0.6 to 0.72, and with major axis parallel to the posterior body margin of T11.
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PMID:Can the thoracic kyphosis be modeled with a simple geometric shape? The results of circular and elliptical modeling in 80 asymptomatic patients. 1213 22

Although radical resection is the best treatment for local aggressive benign tumors or malignant tumors of the spine, total spondylectomy for lower thoracic vertebrae may cause anterior spinal artery syndrome. There are few reports in the literature in which this syndrome has been documented in association with thoracic spondylectomy, although this syndrome is the most common neurologic complication after abdominal aortic surgery. A 50-year-old woman with a giant cell tumor of the thoracic vertebrae was treated by posterior and anterior surgery. Thoracic segmental arteries from T10 to T12 had to be resected bilaterally to dissect the aorta free from the tumor. After resection of all feeding arteries to the tumor, the tumor and entire parts of T10, T11, and T12 were removed. Postoperative neurologic examination disclosed flaccid paralysis of the lower extremities and sphincter incontinence. Although pain and temperature sensation were absent, vibration and position sense were intact, showing anterior spinal artery syndrome. Intraoperative somatosensory-evoked potential monitoring only showed that transient deterioration failed to adequately reflect this neurologic injury. Major reconstructive surgery involving lower thoracic regions may cause anterior spinal artery syndrome. Somatosensory-evoked potential monitoring might not reliably predict overall neurologic outcome involving the blood supply of the lower thoracic regions.
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PMID:Anterior spinal artery syndrome after total spondylectomy of T10, T11, and T12. 1246 71

The objective is to present the possibility of an association between spinal epidural abscess and IgG deficiency. Spinal epidural abscess is a rare but potentially devastating condition. Review of the literature showed no reported acknowledgment about the relationship between spinal epidural abscess and IgG deficiency. This report discusses the case of a 16-year-old boy who developed progressive paraplegia within 24 hours. Clinical and neuroradiologic features are reported. Serum quantitative total IgG, IgA, and IgM concentrations were measured by nephelometry. Thoracic magnetic resonance imaging showed epidural abscess between T6 and T11 compressing the cord posteriorly. IgG subclasses (IgG ) were found abnormal. The possible importance of immunologic evaluation in the patients with spinal epidural abscess when no source of infection could be find is discussed.(4) (4) (4)
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PMID:Spinal epidural abscess associated with IgG4 deficiency. 1257 93

The purpose of this study was to measure precision of thoracic quantitative computed tomography (QCT) bone mineral density (BMD) and correlation to lumbar spine QCT bone density. We measured the reproducibility of thoracic QCT; two consecutive thoracic QCT scans of the T9, T10, and T11 vertebrae were performed on 95 subjects (49 females, 46 males; mean age, 62.5 years) undergoing coronary scanning. In order to correlate the thoracic to standard lumbar measurement, the subjects also underwent a lumbar QCT scan of the L1, L2, and L3 vertebrae as part of an abdominal aortic scanning study. The variation of thoracic BMD was assessed in different ethnic subgroups. Consecutive thoracic QCT measurements showed good agreement (r=0.98; RMS CV=5.78%). Thoracic bone density was significantly higher than lumbar bone density results (paired t-test, P=0.003), but the two methods correlated well (r=0.86). The regression equation for the relationship between lumbar (X) and thoracic (Y) QCT was Y=0.87X + 22.97. The standard error of estimate was 19.0 mg/cm3. Thoracic QCT from coronary calcium thoracic scans is able to measure BMD with rescan precision and regression errors that are small compared to the biologic variability in the population. Given the relatively small precision error and the reasonable correlation to lumbar BMD, an ancillary assessment of thoracic BMD in a cardiac scan is likely to be a useful assessment of bone mineral status in the general population.
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PMID:Validation of thoracic quantitative computed tomography as a method to measure bone mineral density. 1545 85


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