Study DesignThis is a retrospective study.PurposeWe wanted to measure the distance of the normal intervetebral disc space of Koreans.Overview of the LiteratureFor judging the distance of the normal intervertebral disc space of Koreans, we studied young adults who didn't have degenerative spinal change to determine the distance of the normal intervertebral disc space of each lumbar vertebral segment, and we did so by performing magnetic resonance imaging (MRI).MethodsWe studied a total of 178 outpatients who had low back pain and they underwent lumbar MRI. There were 138 males and 40 females, and their average age was 20.7 years (range, 15 to 25 years). On MRI, the segments with observed Modic change or other abnormalities were excluded from this investigation. To improvement the accuracy of measurement, two spine specialists measured the distances 2 times, and we calculated the mean value. We used paired t-tests for statistical analysis.ResultsIn the total 178 patients, the average distance of intervertebral space from the 1st to the 2nd lumbar vertebrae was 24.83% (range, 18 to 32%), that from the 2nd to the 3rd was 26.92% (range, 19 to 40%), that from the 3rd to 4th was 28.88% (range, 19 to 41%), that from the 4th to 5th was 29.60% (range, 21 to 43%) and that from the 5th lumbar vertebra to the 1st sacrum was 27.52% (range, 19 to 38%).ConclusionsIn this study, we expect that knowing the normal distance of the lumbar intervertebral space of Koreans can be helpful for surgical reconstruction to treat many lumbar spine diseases, to predict the appropriate size of the devices inserted in the intervertebral space and to produce proper devices for Koreans.
F-18 sodium-fluoride (NaF) bone positron emission tomography (PET/CT) has been used for diagnosing various bone and joint diseases, and, with using dual-phase scan protocol, it could give the same information obtained by the 3-phase bone scintigraphy. The present study aimed to evaluate the diagnostic ability of dual-phase F-18 NaF bone PET/CT in detecting surgical site infection after orthopedic surgery.Twenty-three patients who underwent dual-phase F-18 NaF bone PET/CT under clinical suspicion of surgical site infection of the bone following orthopedic surgery were enrolled in this study. Dual-phase bone PET/CT consisted of an early phase scan performed immediately after radiotracer injection and a conventional bone-phase scan. All dual-phase PET/CT images were visually assessed, and, for quantitative analysis, 6 parameters of dual-phase PET/CT (lesion-to-blood pool uptake ratio, lesion-to-bone uptake ratio, and lesion-to-muscle uptake ratio on both early phase and bone-phase scans) were measured.Surgical site infection was diagnosed in 14 patients of the 23 patients. The sensitivity, specificity, and accuracy of visual analysis of dual-phase F-18 NaF bone PET/CT for diagnosing surgical site infection of the bone were 92.9%, 100.0%, and 95.7%, respectively. Among the 6 parameters, the lesion-to-blood pool uptake ratio on early phase scan showed the highest area under the receiver operating characteristic curve value (0.857, 95% confidence interval, 0.649–0.966), with the cut-off value of 0.88 showing sensitivity, specificity, and accuracy of 85.7%, 88.9%, and 87.0%, respectively.Our study showed the high diagnostic ability of dual-phase F-18 NaF bone PET/CT for detecting surgical site infection following orthopedic surgery. Further studies are needed to compare the diagnostic ability of dual-phase bone PET/CT with other imaging modalities.
Rationale:Tarsal tunnel syndrome (TTS) is a compressive neuropathy of the posterior tibial nerve or one of its branches within the tarsal tunnel that is often caused by a variety of space-occupying lesions, such as ganglia, lipomas, varicosities, neural tumors, trauma, or systemic disease. The os sustentaculi is a small accessory bone, bridged to the posterior aspect of the sustentaculum tali by fibrocartilage. To the best of our knowledge, this is a rare case of successful treatment of TTS caused by the os sustantaculi.Patient concerns:A 37-year-old male presented with insidious onset of right ankle and foot pain for 1 year. He also complained of a tingling sensation and paresthesia from the plantar and medial aspect of the forefoot to the middle foot area along the main distribution of the medial plantar nerve. The symptoms were mild at rest, but increased upon prolonged walking. He had an ankle sprain history during a football game 2 years previously and recurrent ankle sprains had occurred more frequently in this ankle since that trauma.Diagnoses:Plain standing anteroposterior and lateral view radiographic findings of the right ankle reveled an accessory ossicle located posterosuperomedial to the sustentaculum tali. A computed tomography scan showed that the ossicle articulated between the talus and calcaneus. A magnetic resonance image revealed mild bone marrow edema in the ossicle and medial displacement of the tarsal structures.Interventions:Surgery was performed under general anesthesia. The ossicle was delineated from its surrounding structures and was removed. Tension on the nerve was released.Outcomes:The patient's pain and hypoesthesia were immediately relieved, and the tingling sensation disappeared 6 months after surgery. The patient had no complications or recurrence of symptoms at the 1-year follow-up.
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