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Diagnostics
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Spine Surgery: State of the Art Diagnostics
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Spine Surgery: State of the Art Diagnostics

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 August 2021) | Viewed by 11218

Special Issue Editors

Dr. Matthias Pumberger

E-Mail Website
Guest Editor
Charité—Universitätsmedizin Berlin, Berlin, Germany
Interests: spine; lumbar; cervical; fusion; low back pain; infection; revision
Dr. Torsten Diekhoff

E-Mail Website
Guest Editor
Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
Interests: DE-CT; rheumatology; gout; spine; lumbar; fusion; low back pain
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

Diagnostics plays an outstanding role in spinal surgery. It is an indispensable part of the therapeutic decision making process and the prevention of complications. The importance of diagnostics has and will continue to evolve in the coming years due to the increasing complexity of surgical procedures. Spine surgery is broadly based on and cooperates interdisciplinary closely with neurosurgery, orthopedics, radiology, pain physicians or physiotherapy. This Special Issue focuses on the widespread scope of diagnostic measures related to alignment, infections, innovative imaging, peri-operative complications, and musculoskeletal interactions.

We encourage authors to submit their original research and reviews on spinal-related diagnostics.

Dr. Matthias Pumberger
Dr. Torsten Diekhoff
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Spinal fusion
  • Low back pain
  • Infection
  • Revision surgery
  • Dual-energy CT
  • Alignment
  • Spinal complications

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Published Papers (4 papers)

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Research

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8 pages, 1757 KiB  
Article
Assessment of 3D Lumbosacral Vascular Anatomy for OLIF51 by Non-Enhanced MRI and CT Medical Image Fusion Technique
by Masakazu Nagamatsu, Sameer Ruparel, Masato Tanaka, Yoshihiro Fujiwara, Koji Uotani, Shinya Arataki, Taro Yamauchi, Yoshiyuki Takeshita, Rika Takamoto, Masato Tanaka and Shinsuke Moriue
Diagnostics 2021, 11(10), 1744; https://doi.org/10.3390/diagnostics11101744 - 23 Sep 2021
Cited by 9 | Viewed by 2064
Abstract
Study design: Prospective study. Objective: Medical image fusion can provide information from multiple modalities in a single image. The present study aimed to determine whether three-dimensional (3D) lumbosacral vascular anatomy could be adequately portrayed using a non-enhanced CT–MRI medical image fusion technique. Summary [...] Read more.
Study design: Prospective study. Objective: Medical image fusion can provide information from multiple modalities in a single image. The present study aimed to determine whether three-dimensional (3D) lumbosacral vascular anatomy could be adequately portrayed using a non-enhanced CT–MRI medical image fusion technique. Summary of Background Data: Lateral lumbar interbody fusion has gained popularity for the surgical treatment of adult spinal deformity (ASD). Oblique lumbar interbody fusion at L5–S1 (OLIF51) is receiving considerable attention as a method of creating good L5–S1 lordosis. Access in OLIF51 requires evaluation of the vascular anatomy in the lumbosacral region. Conventional imaging modalities need a contrast medium to describe the vascular anatomy. Methods: Participants comprised 15 patients with ASD or degenerative lumbar disease who underwent corrective surgery at our hospital between January 2020 and June 2021. A 3D vascular image with bony structures was obtained by fusing results from MRI and CT. We processed the merged image and measured the distance between left and right common iliac arteries and veins at two levels: the lower end of the L5 vertebral body (Window A) and the upper end of the S1 vertebral body (Window B). Results: The mean sizes of Window A and Window B were 29.7 ± 10.7 mm and 36.9 ± 10.3 mm, respectively. The mean distance from the bifurcation to the lower end of the L5 vertebra was 23.7 ± 10.9 mm. Coronal deviation of the bifurcation was, from center to left, 12.6 ± 12.3 mm, and the distance from the center of the L5 vertebral body to the bifurcation was 0.79 ± 7.3 mm. Only one case showed a median sacral vein (6.7%). Clinically, we performed OLIF51 in 12 of the 15 cases (80%). Conclusion: Evaluating 3D lumbosacral vascular anatomy using a non-enhanced MRI and CT medical image fusion technique is very useful for OLIF51, particularly for patients in whom the use of contrast medium is contraindicated. Full article
(This article belongs to the Special Issue Spine Surgery: State of the Art Diagnostics)
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12 pages, 3417 KiB  
Article
Changes of Fixed Anatomical Spinopelvic Parameter in Patients with Lumbosacral Transitional Vertebrae: A Matched Pair Analysis
by Henryk Haffer, Luis Becker, Michael Putzier, Mats Wiethölter, Katharina Ziegeler, Torsten Diekhoff, Matthias Pumberger and Sebastian Hardt
Diagnostics 2021, 11(1), 59; https://doi.org/10.3390/diagnostics11010059 - 2 Jan 2021
Cited by 14 | Viewed by 3269
Abstract
Functional spinopelvic parameters are crucial for describing spinal alignment (SA), but this is susceptible to variation. Anatomically fixed pelvic shape is defined by the parameters pelvic radius (PR), pelvic incidence (PI), and sacral table angle (STA). In patients with lumbosacral transitional vertebrae (LSTV), [...] Read more.
Functional spinopelvic parameters are crucial for describing spinal alignment (SA), but this is susceptible to variation. Anatomically fixed pelvic shape is defined by the parameters pelvic radius (PR), pelvic incidence (PI), and sacral table angle (STA). In patients with lumbosacral transitional vertebrae (LSTV), the spinopelvic alignment may be altered by changes of these parameters and influences of SA. There have been no reports studying the relation between LSTV, four (4 LV) and six (6 LV) lumbar vertebrae, and fixed anatomical spinopelvic parameters. A retrospective analysis of 819 abdomen–pelvis CT scans was performed, identifying 53 patients with LSTV. In a matched-pair analysis, we analyzed the influence of LSTV and the subgroups 4 LV (n = 9) and 6 LV (n = 11) on PR, PI, and STA. LSTV were classified according to Castellvi classification. In patients with 6 LV, measurement points at the superior endplates of S1 and S2 were compared. The prevalence of LSTV was 6.5% (53/819), 6 LV was 1.3% (11/819), and 4 LV was 1.1% (9/819) in our study population. PI significantly increased (p < 0.001), STA significantly decreased (p < 0.001), and PR (p = 0.051) did not differ significantly in the LSTV group (n = 53). Similar findings were observed in the 4 LV subgroup, with an increase in PI (p < 0.021), decrease in STA (p < 0.011), and no significant difference in PR (p < 0.678). The same results were obtained in the 6 LV subgroup at measuring point S2 (true S1) PI (p = 0.010), STA (p = 0.004), and PR (p = 0.859), but not at measuring point S1 (true L6). Patients with LSTV, 4 LV, and 6 LV showed significant differences in PI and STA compared to the matched control group. PR showed no significant differences. The altered spinopelvic anatomy in LSTV patients need to be reflected in preoperative planning rebalancing the sagittal SA. Full article
(This article belongs to the Special Issue Spine Surgery: State of the Art Diagnostics)
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Review

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12 pages, 244 KiB  
Review
The Role of Diagnostic Injections in Spinal Disorders: A Narrative Review
by Brian Y. Kim, Tyler A. Concannon, Luis C. Barboza and Talal W. Khan
Diagnostics 2021, 11(12), 2311; https://doi.org/10.3390/diagnostics11122311 - 9 Dec 2021
Cited by 4 | Viewed by 2774
Abstract
Neck and back pain is increasingly prevalent, and has increased exponentially in recent years. As more resources are dedicated to the diagnosis of pain conditions, it is increasingly important that the diagnostic techniques used are as precise and accurate as possible. Traditional diagnostic [...] Read more.
Neck and back pain is increasingly prevalent, and has increased exponentially in recent years. As more resources are dedicated to the diagnosis of pain conditions, it is increasingly important that the diagnostic techniques used are as precise and accurate as possible. Traditional diagnostic methods rely heavily upon patient history and physical examination to determine the most appropriate treatments and/or imaging studies. Though traditional means of diagnosis remain a necessity, in many cases, correlation with positive or negative responses to injections may further enhance diagnostic specificity, and improve outcomes by preventing unnecessary treatments or surgeries. This narrative review aims to present the most recent literature describing the diagnostic validity of precision injections, as well as their impact on surgical planning and outcomes. Diagnostic injections are discussed in terms of facet arthropathy, lumbar radiculopathy, discogenic pain and discography, and sacroiliac joint dysfunction. There is a growing body of evidence supporting the use of diagnostic local anesthetic injections or nerve blocks to aid in diagnosis. Spinal injections add valuable objective information that can potentially improve diagnostic precision, guide treatment strategies, and aid in patient selection for invasive surgical interventions. Full article
(This article belongs to the Special Issue Spine Surgery: State of the Art Diagnostics)

Other

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7 pages, 3536 KiB  
Technical Note
Percutaneous C-Arm Free O-Arm Navigated Biopsy for Spinal Pathologies: A Technical Note
by Masato Tanaka, Sumeet Sonawane, Koji Uotani, Yoshihiro Fujiwara, Kittipong Sessumpun, Taro Yamauchi and Shinsuke Sugihara
Diagnostics 2021, 11(4), 636; https://doi.org/10.3390/diagnostics11040636 - 1 Apr 2021
Cited by 4 | Viewed by 2294
Abstract
Background: Percutaneous biopsy under computed tomography (CT) guidance is a standard technique to obtain a definitive diagnosis when spinal tumors, metastases or infections are suspected. However, specimens obtained using a needle are sometimes inadequate for correct diagnosis. This report describes a unique biopsy [...] Read more.
Background: Percutaneous biopsy under computed tomography (CT) guidance is a standard technique to obtain a definitive diagnosis when spinal tumors, metastases or infections are suspected. However, specimens obtained using a needle are sometimes inadequate for correct diagnosis. This report describes a unique biopsy technique which is C-arm free O-arm navigated using microforceps. This has not been previously described as a biopsy procedure. Case description: A 74-year-old man with T1 vertebra pathology was referred to our hospital with muscle weakness of the right hand, clumsiness and cervicothoracic pain. CT-guided biopsy was performed, but histopathological diagnosis could not be obtained due to insufficient tissue. The patient then underwent biopsy under O-arm navigation, so we could obtain sufficient tissue and small cell carcinoma was diagnosed on histopathological examination. A patient later received chemotherapy and radiation. Conclusions: C-arm free O-arm navigated biopsy is an effective technique for obtaining sufficient material from spine pathologies. Tissue from an exact pathological site can be obtained with 3-D images. This new O-arm navigation biopsy may provide an alternative to repeat CT-guided or open biopsy. Full article
(This article belongs to the Special Issue Spine Surgery: State of the Art Diagnostics)
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