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Jonathan N Grauer

Publications and source records attributed to Jonathan N Grauer.

At least 19 recordsLinked to original sources
PubMed2007

The use of rigid internal fixation in the surgical management of cervical spondylosis.

In the surgical management of cervical spondylosis, the application of rigid internal fixation can enhance the immediate stability of the cervical spine. The sophistication of such internal fixation systems and the indications for their use are continuously evolving. A sound understanding of regional anatomy, biomechanics, and kinematics within the cervical spine is essential for the safe and effective application of internal fixation. Numerous options currently exist for anterior cervical plating systems; some lock the screws to the plate rigidly (constrained), whereas others allow for some rotational or translational motion between the screw and plate (semiconstrained). The role of anterior fixation in single and multilevel fusions is still the subject of some controversy. Long anterior cervical reconstructions may require additional posterior fixation to reliably promote fusion. Rigid fixation in the posterior cervical spine can be achieved with lateral mass screws or pedicle screws. Although lateral mass screws provide excellent fixation within the subaxial cervical spine, the regional anatomy of C2 and C7 often make it difficult to place such screws, and pedicle screws at these levels are advocated. Pedicle screws achieve fixation into both the anterior and posterior column and are arguably the most stable form of rigid internal fixation within the cervical spine. Familiarity with these internal fixation techniques can be an extremely valuable tool for the spine surgeon managing these degenerative disorders of the cervical spine.

Cervical Vertebrae↗
PubMed2006

Osteogenic protein-1 induced gene expression: evaluation in a posterolateral spinal pseudarthrosis model.

STUDY DESIGN: Molecular study of gene expression in rabbit lumbar pseudarthrosis repairs using reverse transcriptase polymerase chain reaction. OBJECTIVE: To evaluate differential gene expression of no graft, autograft, and osteogenic protein-1 treated pseudarthroses. SUMMARY OF BACKGROUND DATA: Osteogenic protein-1 is a potential bone graft alternative that has achieved high fusion rates in a rabbit lumbar fusion model, including in the repair of nicotine-induced pseudarthroses. A previous study established a correlation between osteogenic protein-1 fusion outcomes and an enhanced level of cytokine gene expression. The expression of such cytokines is known to be decreased in nicotine-exposed rabbit fusion masses. METHODS: Messenger ribonucleic acid was isolated from nicotine-exposed New Zealand white rabbit lumbar pseudarthroses following attempted no graft, autograft, and osteogenic protein-1 pseudarthrosis repairs. Reverse transcriptase polymerase chain reaction was used to assess the expression of angiogenin, angiopoietin, intercellular adhesion molecule, platelet-derived growth factor-beta, vascular endothelial growth factor, bone morphogenetic proteins 2 and 7, type I collagen, and osteonectin. Glyceraldehyde-3-phosphate dehydrogenase was used as a constitutively expressed control. RESULTS: Levels of gene expression in the osteogenic protein-1 group were higher than those of the autograft group, which were higher than the no graft group for the majority of the genes studied. CONCLUSIONS: In the rabbit pseudarthrosis model, gene expression data supported the hypothesis that successful pseudarthrosis repair is related to the induction of osteogenic and angiogenic cytokines by osteogenic protein-1.

Animals↗
PubMed2006

Biomechanics of two-level Charité artificial disc placement in comparison to fusion plus single-level disc placement combination.

BACKGROUND CONTEXT: Biomechanical studies of artificial discs that quantify parameters such as load sharing and stresses have been reported in literature for single-level disc placements. However, literature on the effects of using the Charité artificial disc (ChD) at two levels (2LChD) as compared with one-level fusion (using a cage [CG] and a pedicle screw system) plus one-level artificial disc combination (CGChD) is sparse. PURPOSE: To determine the effects of the 2LChD and CGChD across the implanted and adjacent segments. STUDY DESIGN: A finite element model of a L3-S1 segment was used to compare the biomechanical effects of the ChD placed at two lower levels (2LChD model) with L5-S1 fusion (using a CG and a pedicle screw system) plus L4-L5 level ChD placement combination (CGChD model). METHODS: We used our recently published and experimentally validated L3-S1 finite element model for the present study. The intact model was subjected to 400 N axial compression and 10.6 Nm of flexion/extension moments. The experimental constructs described above were then subjected to 400 N axial compression and a moment that produced overall motion equal to the intact model predictions (hybrid testing protocol). Resultant motion, loads across facets, and other parameters were analyzed at the experimental and adjacent levels. RESULTS: In flexion, the bending moments for the CGChD and 2LChD models were 15.4 Nm (fusion effect) and 7.3 Nm (increase in flexibility effect), respectively in comparison to 10.6 Nm for the intact model. The corresponding values in the extension mode were 11.2 Nm and 7.2 Nm. The predicted flexion rotations across the L5-S1 segment for the CGChD decreased by 76% (fusion effect), and increased at the L4-L5 and the L3-L4 levels by 68.5% and 28%, respectively. In the extension mode, motion across the L5-S1 segment decreased by 96.4% whereas it increased 74.6% and 18.2% across the L4-L5 and L3-L4 levels, respectively. For the 2LChD model, the flexion rotation across the L5-S1 segment increased by 28.2%. The motions across the L4-L5 and L3-L4 segments decreased by 12% and 24%, respectively. In extension, the corresponding changes were 10% increase, 10% increase, and 21% decrease at the L5-S1, L4-L5, and L3-L4 levels, respectively. The facet loads were in line with the changes in motion, except for the 2LChD case. CONCLUSIONS: The changes at L3-L4 level for both of the cases were of similar magnitude (approximately 25%), although in the CGChD model it increased and in the 2LChD model it decreased. The changes in motion at the L4-L5 level were large for the CGChD model as compared with the 2LChD model predictions (approximately 70% increase vs. 10% increase). It is difficult to speculate if an increase in motion across a segment, as compared with the intact case, is more harmful than a decrease in motion.

Biomechanical Phenomena↗
PubMed2006

Healos/recombinant human growth and differentiation factor-5 induces posterolateral lumbar fusion in a New Zealand white rabbit model.

STUDY DESIGN: Posterolateral lumbar spine fusions in New Zealand white rabbits. OBJECTIVE: To evaluate the efficacy of recombinant human growth and differentiation factor-5 (rhGDF-5) lyophilized to a Healos carrier (cross-linked type I collagen with hydroxyapatite coating; DePuy Spine, Inc., Raynham, MA) in inducing fusion. SUMMARY OF BACKGROUND DATA: Bone graft substitutes have become an area of considerable interest. rhGDF-5 is one such product. Limited lumbar preclinical studies have been performed with this product. METHODS: Single-level, intertransverse process fusions were performed in 67 rabbits using iliac crest autograft (n = 13), Healos alone (n = 13), or 0.5, 1.0, or 1.5 mg/cc rhGDF-5 lyophilized to Healos (n = 13 per group). At 8 weeks, the rabbits were euthanized. Fusion masses were assessed. RESULTS: There were 2 animals (3%) lost to complication. Manual palpation revealed fusion rates for autograft of 38% (5/13), Healos alone of 0% (0/13), and each of the Healos/rhGDF-5 groups of 100% (13/13). Histologic analyses were 95% sensitive and 95% specific for confirming fusion. Histologic differences were found among the treatment groups. CONCLUSIONS: In this rabbit fusion model, Healos/rhGDF-5 induced fusion in 100% of the rabbits studied. This rate was significantly higher than the fusion rate induced by autograft (38%). Overall, these results support continued research of Healos/rhGDF-5 as a potential bone graft alternative.

Animals↗
PubMed2006

An aneurysmal bone cyst in the cervical spine of a 10-year-old girl: a case report.

STUDY DESIGN: An aneurysmal bone cyst in the neural arch of the fourth cervical vertebra of a 10-year-old girl is reported, along with a brief review of the literature on the topic. OBJECTIVE: To report the presentation and diagnosis of this disorder along with a discussion of the major pitfalls of treatment. SUMMARY OF BACKGROUND DATA: An aneurysmal bone cyst occurs commonly in the second decade, with a predilection for the lumbar spine. With occurrence in the neural arch of a cervical vertebra, the potential for instability following surgical excision is high. METHODS: A 10-year-old white female presented with neck pain of 3 months' duration. Diagnostic imaging revealed an expansile lytic lesion in the spinous process and lamina of the fourth cervical vertebra. Surgical treatment consisted of excisional biopsy and a segmental instrumented posterior fusion from C3-C5. The histopathology was consistent with an aneurysmal bone cyst. RESULTS: Surgical excision consisting of laminectomy and instrumented segmental fusion provided a good clinical result, and minimized the risk and degree of the 2 most common complications: recurrence of the tumor; and postlaminectomy kyphosis, a frequent occurrence in the pediatric population. CONCLUSIONS: In pediatric patients who develop a bone tumor of the posterior elements of the cervical spine, careful clinical and radiologic evaluation is necessary to narrow the differential diagnosis. In most cases, a complete excision should be performed if possible. The risk of postlaminectomy kyphosis is high in the pediatric age population. As such, a fusion should be considered whenever a laminectomy is performed in the immature cervical spine. Risk factors for kyphosis include a high cervical level, multiple laminectomy levels, and postoperative irradiation.

Bone Cysts, Aneurysmal↗
PubMed2006

Necrotizing infection of the spine.

STUDY DESIGN: Case report of multifocal necrotizing fasciitis with lumbar involvement. OBJECTIVES: To raise awareness of an unusual, but potential, focus of a multifocal necrotizing infection in a diabetic patient. SUMMARY OF BACKGROUND DATA: Necrotizing fasciitis is a rapidly spreading infection of the soft tissue and fascia. These infections can be polymicrobial, are challenging to treat, and often have grave consequences. The spine may rarely be involved in such infections. METHODS: We describe a patient with long-standing diabetic foot ulcers, which evolved to a necrotizing infection. This infection spread hematogenously to several noncontiguous locations, including the lumbar spine, and was heralded by gas production at the sites of involvement. The spine was treated aggressively and infection eradicated at this site. RESULTS: Despite eradicating the spinal component of this infection, other sites were challenging to clear, and the patient went on to die of multisystem organ failure. CONCLUSIONS: Necrotizing infections rarely involve the spine. Heightened awareness of this potential focus of infection may facilitate its detection. As with other sites, aggressive surgical debridement of this potentially fatal condition is imperative.

Aged↗
PubMed2006

The contemporary treatment of odontoid injuries.

STUDY DESIGN: Review article. OBJECTIVE: To outline current concepts regarding the assessment and treatment of odontoid fractures. SUMMARY OF BACKGROUND DATA: Odontoid fractures account for 9% to 15% of adult, cervical spine fractures. These injuries usually result from hyperflexion or hyperextension of the cervical spine during low-energy impacts in the elderly or high-energy impacts in the young and middle aged. Neurologic injury associated with these fractures is rare. METHODS: A review of pertinent literature was conducted. The information gleaned from this review was summarized. RESULTS: Odontoid fractures should be evaluated with appropriate imaging to assess the fracture itself as well as exclude other contiguous or noncontiguous fractures. The Anderson and D'Alonzo classification system is most commonly used. True type I and III odontoid fractures are generally thought to be relatively stable and are often treated nonoperatively with immobilization. Type II fractures at the base of the odontoid are less stable, and there are differing opinions regarding the precise definition and optimal treatment of these injuries. Nonoperative treatment options for odontoid fractures include external immobilization with a collar or halo. Operative treatment options for odontoid fractures include one of several posterior C1-C2 fusion constructs or anterior odontoid fixation if the fracture pattern is amenable. CONCLUSIONS: Despite the frequency of odontoid fractures, there is still much debate regarding the optimal treatment of these fractures, especially the type II fractures. This fact may be because of the absence of an ideal solution for this clinical problem. Certainly, prospective controlled clinical studies are needed.

Fracture Fixation↗
PubMed2006

Confusion regarding mechanisms of injury in the setting of thoracolumbar spinal trauma: a survey of The Spine Trauma Study Group (STSG).

The Spine Trauma Study Group (STSG) developed the thoracolumbar injury severity score to direct the management of thoracolumbar spine injuries. The original system is based on 3 variables: the mechanism of injury as determined by imaging studies, the integrity of the posterior ligamentous complex, and the neurologic status of the patient. Considerable controversy exists among treating physicians in classifying injury mechanisms. The purpose of this study was to survey the STSG on case examples related to the mechanism of thoracolumbar injury. A 2-question survey regarding thoracolumbar injury mechanisms and scoring was distributed to members of the STSG. A total of 27 STSG members completed surveys on defining and scoring thoracolumbar injury mechanisms. Data from these completed surveys were analyzed using a 2-tailed Fisher exact test on a chi2 contingency table. Sixty-seven percent of physicians preferred a definition incorporating posterior ligamentous complex disruption without posterior vertebral body retropulsion over the location of the axis of rotation in differentiating flexion-distraction from advanced stage flexion-compression injuries, representing a statistically significant difference (P=0.0285). There was no statistical consensus on the scoring emphasizing a primary and secondary mechanism of injury in complex injury patterns. Despite the statistical consensus to 1 survey question, there seems to be no dominating opinion on distinguishing thoracolumbar injury mechanisms. Perhaps identifying objective findings on imaging studies and clinical examination in place of guessing injury mechanisms may allow for a more reliable and valid thoracolumbar injury classification system.

Attitude of Health Personnel↗
PubMed2006

Subaxial cervical spine trauma.

Subaxial cervical spine injuries are common, ranging in severity from minor ligamentous strain or spinous process fracture to complete fracture-dislocation with bone and ligament failure, resulting in severe spinal cord injury. Understanding the epidemiology, anatomy, biomechanics, and classification of subaxial cervical spine injuries is important. Emergent management of such injuries is based on obtaining an accurate clinical history, careful physical examination, and organized radiographic evaluation. Attaining a unified approach to the wide spectrum of subaxial cervical injuries is difficult. In addition, controversy exists regarding the safety of closed reduction in certain injury patterns and the administration of methylprednisolone for acute spinal cord injury. Definitive management (surgical or nonsurgical) is based on the assessment of the mechanical instability of the injury, the presence or absence of neurologic impairment, and various patient factors that may influence outcome. Several complications, including the deterioration of neurologic status, may occur with either surgical or nonsurgical management, but the most frequent mistake made is missing the injury on initial evaluation.

Biomechanical Phenomena↗
PubMed2006

Metastatic disease of the spine.

Metastatic spine disease accounts for 10% to 30% of new cancer diagnoses annually. The most frequent presentation is axial pain. A thorough spinal examination includes assessment of local tenderness, deformity, limitation of motion, and signs of nerve root or cord compression. Plain radiographs are obtained routinely; for a suspected or known malignancy, radionuclide studies are essential. Magnetic resonance imaging is more specific than bone scans. Computed tomography-guided biopsy is considered to be safe and accurate for evaluating spinal lesions. Treatment is multidisciplinary, and virtually all treatment is palliative. Management is guided by three key issues: neurologic compromise, spinal instability, and individual patient factors. Site-directed radiation, with or without chemotherapy, is the mainstay of treating painful lesions that are not impinging on neural elements. New data documenting the benefit of surgical decompression using improved techniques such as anterior approaches have amplified the role of the spine surgeon in the care of these patients.

Decompression, Surgical↗
PubMed2006

Back pain in athletes.

The athlete with back pain presents a clinical challenge. Self-limited symptoms must be distinguished from persistent or recurrent symptoms associated with identifiable pathology. Athletes involved in impact sports appear to have risk factors for specific spinal pathologies that correlate with the loading and repetition demands of specific activities. For example, elite athletes who participate in longer and more intense training have higher incidence rates of degenerative disk disease and spondylolysis than athletes who do not. However, data suggest that the recreational athlete may be protected from lumbar injury with physical conditioning. Treatment of athletes with acute or chronic back pain usually is nonsurgical, and symptoms generally are self-limited. However, a systematic approach to the athlete with back pain, involving a thorough history and physical examination, pertinent imaging, and treatment algorithms designed for specific diagnoses, can facilitate symptomatic improvement and return to play. There are no reliable studies examining the long-term consequences of athletic activity on the lumbar spine.

Athletic Injuries↗
PubMed2005

Effects of charité artificial disc on the implanted and adjacent spinal segments mechanics using a hybrid testing protocol.

STUDY DESIGN: Finite element model of L3-S1 segment and confirmatory cadaveric testing were used to investigate the biomechanical effects of a mobile core type artificial disc (Charité artificial disc; DePuy Spine, Raynham, MA) on the lumbar spine. OBJECTIVE: To determine the effects of the Charité artificial disc across the implanted and adjacent segments. SUMMARY OF BACKGROUND DATA: Biomechanical studies of artificial discs that quantify parameters, like the load sharing and stresses, are sparse in the literature, especially for mobile-type core artificial disc designs. In addition, there is no standard protocol for studying the adjacent segmental effects of such implants. METHODS: Human osteo-ligamentous spines (L1-S1) were tested before and after L5-S1 Charité artificial disc placement. The data were used to validate further an intact 3-dimensional (3-D) nonlinear L3-S1 finite element model. The model was subjected to 400-N axial compression and 10.6 Nm of flexion/extension pure moments (load control) or pure moments that produced the overall rotation of the L3-S1 Charité model equal to the intact case (hybrid approach). Resultant motion, load, and stress parameters were analyzed at the experimental and adjacent levels. RESULTS: Finite element model validation was achieved only with the load-controlled experiments. The hybrid approach, believed to be more clinically relevant, revealed that Charité artificial disc leads to motion increases in flexion (19%) and extension (44%) at the L5-S1 level. At the instrumented level, the decrease in the facet loads was less than at the adjacent levels; the corresponding decrease being 26% at L3-L4, 25% at L4-L5, and 13.4% at L5-S1 when compared to the intact. Intradiscal pressure changes in the L4-L5 and L3-L4 segments were minimal. Shear stresses at the Charité artificial disc-L5 endplate interface were higher than those at S1 interface. However, in the load control mode, the increase in facet loads in extension was approximately 14%, as compared to the intact case. CONCLUSIONS: The hybrid testing protocol is advocated because it better reproduces clinical observations in terms of motion following surgery, using pure moments. Using this approach, we found that the Charité artificial disc placement slightly increases motion at the implanted level, with a resultant increase in facet loading when compared to the adjacent segments, while the motions and loads decrease at the adjacent levels. However, in the load control mode that we believe is not that clinically relevant, there was a large increase in motion and a corresponding increase in facet loads, as compared to the intact.

Biomechanical Phenomena↗
PubMed2005

Industry support and correlation to study outcome for papers published in Spine.

STUDY DESIGN: Retrospective review of articles published in the journal Spine. OBJECTIVES: To evaluate potential correlations between research sponsorship and study outcome. SUMMARY OF BACKGROUND DATA: Industry sponsorship has traditionally been associated with more positive results than non-funded or peer-reviewed funded projects in other areas of medicine. The association of such sponsorship and study outcome has not been addressed previously in spine research. METHODS: Articles from the journal Spine from January 2002 to July 2003 were reviewed. These were examined for the subject evaluated, type of study design, funding source, and conclusion reached. RESULTS: Of 1143 articles, 527 met inclusion criteria of having abstract, materials/methods, and conclusion sections. Industry support was reported for 84 (15.9%), foundation support for 67 (12.7%), government support for 54 (10.2%), institution support for 17 (3.2%), and no funding was reported for 304 (57.9%). The odds ratio of industry funded reporting positive results was 3.3 times that of studies with any other funding sources (P < 0.001). CONCLUSIONS: Industry funded studies demonstrated a statistically greater likelihood to report positive results than studies with other funding sources. Potential explanations for this are biased study design, biased experimental technique, biased result interpretation, or publication bias. Although the expense of research and limited funding sources have forced an increased reliance on industry support for funding basic science and clinical spine research, this does introduce the potential for bias and must be recognized by the reader.

Bibliometrics↗
PubMed2004

Comparison of posterolateral lumbar fusion rates of Grafton Putty and OP-1 Putty in an athymic rat model.

STUDY DESIGN: Posterolateral lumbar spine fusions in athymic rats. OBJECTIVES: To compare spine fusion rates of two different osteoinductive products. SUMMARY OF BACKGROUND DATA: Many osteoinductive bone graft alternatives are available. Grafton (a demineralized bone matrix [DBM]) and Osteogenic Protein-1 (OP-1, an individual recombinant bone morphogenetic protein) are two such alternatives. The relative efficacy of products from these two classes has not been previously studied. The athymic rat spine fusion model has been validated and demonstrated useful to minimize inflammatory responses to xenogeneic or differentially expressed proteins such as those presented by DBMs of human etiology. METHODS: Single-level intertransverse process fusions were performed in 60 athymic nude rats with 2 cc/kg of Grafton or OP-1 Putty. Half of each study group was killed at 3 weeks and half at 6 weeks. Fusion masses were assessed by radiography, manual palpation, and histology. RESULTS: At 3 weeks, manual palpation revealed a 13% fusion rate with Grafton and a 100% fusion rate with OP-1 (P = 0.0001). At 6 weeks, manual palpation revealed a 39% fusion rate of with Grafton and a 100% fusion rate with OP-1 (P = 0.0007). Similar fusion rates were found by histology at 3 and 6 weeks. Of note, one or two adjacent levels were fused in all of the OP-1 animals and none of the Grafton animals. CONCLUSIONS: Significant differences between the ability of Grafton and OP-1 to induce bone formation in an athymic rat posterolateral lumbar spine fusion model were found.

Activin Receptors, Type I↗
PubMed2004

Development of a New Zealand white rabbit model of spinal pseudarthrosis repair and evaluation of the potential role of OP-1 to overcome pseudarthrosis.

STUDY DESIGN: Posterolateral lumbar fusions were performed in nicotine-exposed, New Zealand white rabbits. Animals that developed a pseudarthrosis were then regrafted with no graft, autograft, or osteogenic protein-1 (OP-1). OBJECTIVES: To establish a model of pseudarthrosis repair and to evaluate the ability of OP-1 to induce fusion in this model. SUMMARY OF BACKGROUND DATA: OP-1 has been shown to have a 100% fusion rate in an established rabbit fusion model, even in the presence of nicotine, which is known to inhibit fusion. METHODS: Forty-four New Zealand white rabbits underwent posterolateral lumbar fusion with iliac crest autograft. To maximize the incidence of pseudarthroses, nicotine was administered to all rabbits. At 5 weeks, the spines were explored, and all pseudarthroses were redecorticated and grafted with no graft, autograft, or OP-1. At 10 weeks, the rabbits were killed and fusions masses were assessed with manual palpation, radiography, computed tomography, and/or histology. RESULTS: Nine rabbits (20%) were lost to complications. Thirty-four (94%) had pseudarthroses on exploration at 5 weeks. By manual palpation at 10 weeks, 1 of 10 (10%) pseudarthroses that received no graft fused, 5 of 12 (42%) pseudarthroses that received autograft fused, and 9 of 11 (82%) pseudarthroses that received OP-1 fused. Computed tomography and histology further characterized the fusion masses. CONCLUSIONS: This study establishes a model for treatment of pseudarthroses. OP-1, which has previously been shown to have 100% fusion rate in animal models, outperformed autograft and induced fusion in 82% of rabbits.

Animals↗
PubMed2004

Similarities and differences in the treatment of spine trauma between surgical specialties and location of practice.

STUDY DESIGN: Questionnaires administered to practicing orthopedic and neurosurgical spine surgeons from various regions of the United States and abroad. OBJECTIVES: To determine similarities and differences in the treatment of spinal trauma. SUMMARY OF BACKGROUND DATA: Spinal trauma is generally referred to subspecialists of orthopedic or neurosurgical training. Prior studies have suggested that there is significant variability in the management of such injuries. METHODS: Questionnaires based on eight clinical scenarios of commonly encountered cervical, thoracic, and lumbar injuries were administered to 35 experienced spinal surgeons. Surgeons completed profile information and answered approximately one dozen questions for each case. Data were analyzed with SPSS software to determine the levels of agreement and characteristics of respondents that might account for a lack of agreement on particular aspects of management. RESULTS: Of the 35 surgeons completing the questionnaire, 63% were orthopedists, 37% were neurosurgeons, and 80% had been in practice for more than 5 years. Considerable agreement was found in the majority of clinical decisions, including whether or not to operate and the timing of surgery. Of the differences noted, neurosurgeons were more likely to obtain a MRI, and orthopedists were more likely to use autograft as a sole graft material. Physicians from abroad were, in general, more likely to operate and to use an anterior approach during surgery than physicians from the northeastern United States. CONCLUSIONS: More commonalities were identified in the management of spinal trauma than previously reported. When found, variability in opinion was related to professional and regional differences.

Adult↗
PubMed2004

Morphologic evaluation of cervical spine anatomy with computed tomography: anterior cervical plate fixation considerations.

The computed tomography (CT) studies of the cervical spine from 50 males and 50 females were reviewed to provide morphometric data on a variety of anatomic parameters relevant to anterior cervical reconstruction and fixation. Measurements were made of the vertebral body width and midsagittal anteroposterior (AP) diameter and the distance between the medial borders of the longus coli muscles. Distances between adjacent endplates were also measured, both at their midpoint and at the anterior margin. Widths of the vertebral bodies measure 24.6 +/- 2.4 and 23.0 +/- 2.4 mm in males and females, respectively, with the narrowest measuring 17 and 14, respectively. The average midsagittal AP diameter of each vertebral body in males was approximately 17-18 mm, with the smallest AP diameter measured to be 13 mm. The average midsagittal AP diameter of each vertebral body in females was approximately 15-16 mm, with the smallest being 10 mm. CT scanning provides excellent osseous detail for the measurement of such parameters, and with its widespread use in the evaluation of cervical disorders, large numbers of patients can be reviewed.

Adult↗