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Guy Wilms - One of the best experts on this subject based on the ideXlab platform.
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Lumbar artery pseudoaneurysm and arteriovenous fistula as a complication of laparoscopic splenectomy: treatment by transcatheter embolization
European radiology, 2001Co-Authors: Geert Maleux, Jozef Vermylen, Guy WilmsAbstract:Iatrogenic injury of a Lumbar artery is very rare and mostly causes retroperitoneal hemorrhage. We report a case of a Lumbar artery pseudoaneurysm and a concomitant arteriovenous fistula complicating laparoscopic splenectomy and provoking renal colic-like flank pain due to mass effect on the left ureter. Definitive treatment of both vascular lesions was obtained after percutaneous transcatheter embolization of several Lumbar Arteries. Control computed tomography scan 3 months after embolization showed almost complete resorption of the retroperitoneal hematoma.
Sean P. F. Hughes - One of the best experts on this subject based on the ideXlab platform.
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Color Doppler ultrasonography of Lumbar artery blood flow in patients with low back pain.
Spine, 2013Co-Authors: Shima Espahbodi, Caroline J. Doré, Kn Humphries, Sean P. F. HughesAbstract:STUDY DESIGN Prospective, clinical, noninvasive imaging study. OBJECTIVE To quantify normal Lumbar artery hemodynamics and develop a reference range and Lumbar artery hemodynamics in patients with low back pain. SUMMARY OF BACKGROUND DATA Blood supply to the Lumbar spinal tissues, intraosseous capillary circulation, and avascular intervertebral discs derives directly from the Lumbar Arteries. Pathology may affect this blood supply, impact nutrient delivery and contribute to low back pain and disc degeneration. However knowledge of hemodynamic characteristics of Lumbar Arteries is lacking. This could improve understanding into pathological tissue function and its relation to Lumbar spine circulation in back disorders. METHODS Sixty-four patients with low back pain and 30 normal controls underwent Lumbar spine imaging investigations with color Doppler ultrasonography. Doppler data on blood flow was obtained from Arteries at S1 through to L1 bilaterally and angle-corrected peak systolic blood flow velocity (PSV) measured in all vessels. Aortic PSV was used to derive the normalized Lumbar artery: Aortic PSV ratio (PSVR) for all subjects' levels L1 to S1 bilaterally. RESULTS In both the control and low back pain (LBP) groups blood flow PSV in the Lumbar Arteries increased incrementally from levels L1 to L4, declined to its lowest values at L5 and rose again at S1. Normalized Lumbar artery blood flow PSVR in the LBP group is consistently higher at all levels (L1-S1) than in controls (P < 0.001). At level L5, Lumbar artery blood flow PSVR was 46% higher in the LBP group than in controls. CONCLUSION Color Doppler ultrasonography can reliably be used as a clinical tool to visualize and quantify blood flow in Lumbar Arteries of patients with low back disorders. Findings of increased blood flow PSVR in patients are consistent with the well-documented Doppler changes that occur during inflammatory hyperemia. LEVEL OF EVIDENCE 3.
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Colour doppler ultrasound of the Lumbar Arteries: a novel application and reproducibility study in healthy subjects.
Ultrasound in medicine & biology, 2006Co-Authors: Shima Espahbodi, Caroline J. Doré, Kn Humphries, Ian D. Mccarthy, Nigel J. Standfield, David O. Cosgrove, Sean P. F. HughesAbstract:Lumbar Arteries are important because they are the main source of blood supply to the Lumbar spine structures. However, these vessels and their flow characteristics have received little attention and their role in conditions such as low back pain remains unclear. The present study 1. describes the application of duplex ultrasonography in the assessment of Lumbar artery blood flow and 2. evaluates the interobserver and intraobserver reproducibility of Lumbar artery Doppler velocimetry. A total of 13 healthy volunteers were evaluated by two different examiners successively on the same day and measurements repeated by the same examiners I week later. Peak systolic velocities of Lumbar Arteries were recorded at an optimal angle below 60 degrees. Overall mean peak systolic velocity (+/- SD) for Lumbar Arteries was 0.158 +/- 0.051 m/s, and mean Doppler angle (+/- SD) was 24.6 +/- 14.5 degrees. For interobserver variability, the coefficient of variation was 23.4% and SD of differences 0.037 m/s. Reliable results of Lumbar artery Doppler velocimetry demonstrate its applicability in future clinical investigations in patients with low back disorders. (E-mail: shima.espahbodi@imperial.ac.uk) (C) 2006 World Federation for Ultrasound in Medicine & Biology.
Hasan Caglar Ugur - One of the best experts on this subject based on the ideXlab platform.
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Surgical View of the Lumbar Arteries and Their Branches: An Anatomical Study
Operative Neurosurgery, 2011Co-Authors: Mehmet Arslan, Halil İbrahim Açar, Ayhan Comert, Mevci Ozdemir, Alaittin Elhan, Ibrahim Tekdemir, R Shane Tubbs, Hasan Caglar UgurAbstract:Abstract BACKGROUND: Although injury to the Lumbar Arteries during anterior spinal approaches is often encountered, there are few published articles regarding the relationship between the Lumbar Arteries and spinal cord ischemia. OBJECTIVE: To examine the morphology of the Lumbar Arteries and to emphasize their clinical importance. METHODS: With the aid of a surgical microscope, 80 Lumbar Arteries in 10 formalin-fixed male cadavers were studied. Measurements of these structures were made and relationships observed. RESULTS: The spinal artery was usually the first branch of the Lumbar artery. The greatest Lumbar artery diameter was at L4 and had a mean diameter of 3.25 mm; the smallest diameter was identified at L2 and had a mean diameter of 2.05 mm. The largest spinal artery diameter was at L3 (mean, 0.56 mm) and the smallest at L1 (mean, 0.42 mm). The largest anastomotic artery diameter was at L4 (mean, 0.42 mm) and the smallest at L1 (mean, 0.32 mm). For the right and left sides, the mean greatest distance between the origin of the Lumbar artery and the tendinous arch was at L4 (mean, 40.9 and 31.8 mm, respectively) and the least at L1 (mean, 31.8 and 22.5 mm, respectively). The mean of the greatest distance between the anastomotic branch and the base of the transverse process of the Lumbar vertebrae was at L4 (mean, 4.41 and 4.35 mm, respectively) and the smallest at L1 (mean, 4.04 and 4.08 mm, respectively). CONCLUSION: These anatomic findings of the Lumbar segmental Arteries would be useful for emphasizing their surgical importance.
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Surgical view of the Lumbar Arteries and their branches: an anatomical study.
Neurosurgery, 2011Co-Authors: Mehmet Arslan, Halil İbrahim Açar, Ayhan Comert, Mevci Ozdemir, Alaittin Elhan, Ibrahim Tekdemir, R Shane Tubbs, Hasan Caglar UgurAbstract:Although injury to the Lumbar Arteries during anterior spinal approaches is often encountered, there are few published articles regarding the relationship between the Lumbar Arteries and spinal cord ischemia. To examine the morphology of the Lumbar Arteries and to emphasize their clinical importance. With the aid of a surgical microscope, 80 Lumbar Arteries in 10 formalin-fixed male cadavers were studied. Measurements of these structures were made and relationships observed. The spinal artery was usually the first branch of the Lumbar artery. The greatest Lumbar artery diameter was at L4 and had a mean diameter of 3.25 mm; the smallest diameter was identified at L2 and had a mean diameter of 2.05 mm. The largest spinal artery diameter was at L3 (mean, 0.56 mm) and the smallest at L1 (mean, 0.42 mm). The largest anastomotic artery diameter was at L4 (mean, 0.42 mm) and the smallest at L1 (mean, 0.32 mm). For the right and left sides, the mean greatest distance between the origin of the Lumbar artery and the tendinous arch was at L4 (mean, 40.9 and 31.8 mm, respectively) and the least at L1 (mean, 31.8 and 22.5 mm, respectively). The mean of the greatest distance between the anastomotic branch and the base of the transverse process of the Lumbar vertebrae was at L4 (mean, 4.41 and 4.35 mm, respectively) and the smallest at L1 (mean, 4.04 and 4.08 mm, respectively). These anatomic findings of the Lumbar segmental Arteries would be useful for emphasizing their surgical importance.
Osmo Tervonen - One of the best experts on this subject based on the ideXlab platform.
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three year follow up of Lumbar artery occlusion with magnetic resonance angiography in patients with sciatica associations between occlusion and patient reported symptoms
Spine, 2004Co-Authors: Mauno Kurunlahti, Jaro Karppinen, Heikki Vanharanta, Marianne Haapea, Jaakko Niinimaki, Reijo A Autio, I Suramo, Osmo TervonenAbstract:STUDY DESIGN Comparison of occlusion of Lumbar Arteries in magnetic resonance angiography (MRA) with patient-reported sciatica symptoms during a 3-year follow-up. OBJECTIVES To evaluate whether occlusion of Lumbar Arteries is associated with subjective pain symptoms and physical ability among sciatica patients. SUMMARY OF BACKGROUND DATA Cadaveric studies indicate that atherosclerotic manifestations of the abdominal aorta are associated with low back pain (LBP). Impaired blood flow may disturb diffusion of nutrients into the disc, causing degeneration and possibly back pain. METHODS Two-dimensional time-of-flight MRA was used to evaluate Lumbar Arteries at baseline and 3 years. The Arteries on both sides (L1-L4) were evaluated visually and scored as normal, narrowed, or occluded. Incidence of new stenosis was estimated. The associations of stenosis with self-reported previous medical consultations, pain duration through the first year, and number of pain episodes through the last 2 years of follow-up were calculated. Additionally, leg and back pain (10-cm VAS), disability (Oswestry), and self-reported physical ability (self-efficacy) were inquired at 1, 2, and 3 years. In the statistical analysis, bivariate correlation, and the chi or Fisher's test were used. RESULTS MRA was obtained at baseline for 147 patients and at 3 years for 134 patients. Baseline stenosis associated with intensity of back pain at 1 year, leg pain at 2 years, and self-efficacy at every follow-up assessment, but not with disability, previous LBP history, or future pain episodes. The associations of stenosis at 3 years were similar but weaker. Newly formed stenosis was associated with the preceding year's medical consultations due to LBP and prolonged LBP during the first follow-up year. CONCLUSIONS Arterial stenosis is associated strongly and consistently with patient-estimated physical ability,but only slightly with subjective pain symptoms. Interestingly, new stenosis is preceded by pain symptoms. The evaluation of Lumbar blood flow may thus be useful in clinical practice.
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chronic chlamydia pneumoniae infection increases the risk of occlusion of Lumbar segmental Arteries of patients with sciatica a 3 year follow up study
Spine, 2003Co-Authors: Jaro Karppinen, Mauno Kurunlahti, Osmo Tervonen, Paula Mikkonen, Mika Paldanius, Pekka Vasari, Pekka Saikku, Heikki VanharantaAbstract:STUDY DESIGN A magnetic resonance imaging follow-up study of Lumbar Arteries among patients with sciatica with chronic Chlamydia pneumoniae infection. OBJECTIVE To determine whether chronic infection causes occlusion of Lumbar Arteries. SUMMARY OF BACKGROUND DATA C. pneumoniae infection is associated with coronary heart disease, and the infectious pathogen has also been detected in abdominal aortic aneurysms and in atherosclerotic plaques. No studies are available on the effect of this infectious agent on Lumbar Arteries. METHODS Chronic infection was defined as persistent high positive immunoglobulin G and/or immunoglobulin A antibodies and/or the presence of immune complexes. The Lumbar Arteries, evaluated with two-dimensional time-of-flight magnetic resonance angiography, were scored as normal, narrowed, or occluded. The differences in the segmental and whole Lumbar spine (segments L1-L4) sum of arterial occlusion at baseline and at 3 years, and the incidence of new arterial stenosis were compared in patients with and without chronic infection using the Kolmogorov-Smirnov test. RESULTS Patients with chronic infection were more likely to be persistent smokers (P = 0.006), male (P = 0.04), and more obese (P = 0.02) compared to patients with normal antibody levels. They had significantly higher degree of arterial stenosis at L4 segment at baseline and at 3 years (P = 0.001 and 0.002, respectively), in the whole Lumbar spine at baseline and at 3 years (P < 0.001 for both), and at L1 and L3 segments at 3 years (P = 0.013 for both). The incidence of new arterial stenosis was similar in both patient groups. Patients with chronic infection also had significantly higher grade of endplate degeneration at L4-L5 (P = 0.008). CONCLUSIONS The results of this study suggest that chronic C. pneumoniae infection may induce stenosis of Lumbar Arteries.
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Correlation of diffusion in Lumbar intervertebral disks with occlusion of Lumbar Arteries: a study in adult volunteers.
Radiology, 2001Co-Authors: Mauno Kurunlahti, Liisa I. Kerttula, J. Jauhiainen, Jaro Karppinen, Osmo TervonenAbstract:PURPOSE: To evaluate the correlation of the diffusion values in Lumbar intervertebral disks with Lumbar artery status and the degree of disk degeneration. MATERIALS AND METHODS: Sagittal T2-weighted images of the Lumbar spine were obtained in 37 asymptomatic volunteers aged 22–68 years. The apparent diffusion coefficient (ADC) of 98 Lumbar intervertebral disks was determined, and two-dimensional time-of-flight magnetic resonance angiography was performed on the corresponding 98 Lumbar artery pairs (total Arteries = 196). The degree of disk degeneration and the status of Lumbar Arteries were evaluated independently by two radiologists. ADC calculations were performed on the basis of the average signal intensities of the selected region of interest in Lumbar disks. The association between ADC values of disks, the disk degeneration, and the status of Lumbar Arteries of the same level were analyzed with analysis of covariance, and pairwise analysis between groups (Scheffe post hoc multiple comparison) was per...
Geert Maleux - One of the best experts on this subject based on the ideXlab platform.
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Lumbar artery pseudoaneurysm and arteriovenous fistula as a complication of laparoscopic splenectomy: treatment by transcatheter embolization
European radiology, 2001Co-Authors: Geert Maleux, Jozef Vermylen, Guy WilmsAbstract:Iatrogenic injury of a Lumbar artery is very rare and mostly causes retroperitoneal hemorrhage. We report a case of a Lumbar artery pseudoaneurysm and a concomitant arteriovenous fistula complicating laparoscopic splenectomy and provoking renal colic-like flank pain due to mass effect on the left ureter. Definitive treatment of both vascular lesions was obtained after percutaneous transcatheter embolization of several Lumbar Arteries. Control computed tomography scan 3 months after embolization showed almost complete resorption of the retroperitoneal hematoma.
