The configuration of cervical spinous processes in black and white South African skeletal samples

The present study investigates the frequency of bifidity/nonbifidity in the black and white South African populations. Four-hundred skeletons of known race, sex, and tribal group were examined. Spinous processes were classified as bifid (bifurcate and cleft subtypes) and nonbifid (obtuse, pediculate, acinate, and clavate subtypes). Statistical analysis using the chi-squared probability test (p < 0.05) was carried out. Bifid spinous processes were present significantly more frequently in the white sample (58.9%) than in the black (31.6%). A bifid spinous process occurred most commonly in C2 (89%) followed by C5 (83%), C4 (79%), C3 (59.4%), and C6 (41.7%) in the white sample. A similar order of decrease in bifidity occurred in the black sample. C2 most commonly displayed the bifurcate subtype of spinous process, while the clavate subtype of nonbifid spinous process was the most common in both populations. The significantly higher frequency of bifidity in the white South African sample when compared to the black sample may suggest a population difference.     

贴敷疗法配合腰痹方治疗退变性腰椎不稳短期临床疗效评价

目的 观察贴敷疗法配合腰痹方治疗退变性腰椎不稳的短期临床疗效。 方法 将94例退变性腰椎不稳的住院患者分为治疗组和对照组,每组47例,其中治疗组脱落2例,对照组脱落3例。对照组患者接受贴敷疗法,治疗组患者加服腰痹方。采用视觉模拟评分（visual analogue score,VAS）和Oswestry功能障碍指数（Oswestry disability index,ODI）评估临床疗效,采用SF-36量表评估生存质量。 结果 两组治疗10、21 d后,VAS评分和ODI均较治疗前显著降低（P＜0.05）,且治疗组VAS评分和ODI均显著低于对照组（P＜0.05）。治疗21 d后,两组SF-36各维度评分与治疗前比较,差异均有统计学意义（P＜0.05）,治疗组生理机能、生理职能、精力、社会功能4个维度评分升高值显著大于对照组（P＜0.05）。 结论 贴敷疗法配合腰痹方治疗退变性腰椎不稳能减轻疼痛,提高临床疗效及患者生存质量,短期临床疗效满意。     

The Effect of Vertebral Numerical Variation on Anatomical Stature Estimates

Abstract: Most humans possess 24 presacral vertebrae composed of seven cervicals, 12 thoracics, and five lumbars. However, variation from this standard pattern exists. The purpose of this study was to test the effect of congenital vertebral numerical variation on anatomical stature estimates and to recommend appropriate procedures when such variation occurs. Our sample consists of 41 individuals with unusual vertebral count patterns and known cadaveric statures from the Smithsonian’s Terry Collection. Raxter et al. published a revised Fully anatomical technique in 2006 and we used this to estimate living stature. Based on our results, we recommend using the standard anatomical technique to reconstruct stature, regardless of vertebral pattern. However, when an individual possesses six sacral segments together with a normal number of presacral vertebrae, we recommend the addition of a slight correction factor of 1.3 cm or 0.8% of estimated stature.     

基于腰椎高度X线测量技术推断四川汉族女性身高

目的通过腰椎高度X线测量技术,建立四川汉族女性身高的数学模型,为法医人类学研究积累基础数据。方法收集206例四川汉族女性个体按年龄分为A、B、C 3组,其中A组(206例)不分年龄,B组(116例)为20~45岁,C组(90例)为45岁以上,并应用计算机X线摄影(computer radiography,CR)技术分别测量所有样本腰椎CR片中5个椎体(L1~L5)前缘、后缘、中央高度(x1~x15),脊柱腰段中央总长度(x16),同时测量每个个体真实身高,对各测量指标联合与身高的相关性进行线性回归分析,建立推断身高的数学模型,并重新选取62例样本代入数学模型,检验模型的准确性。结果所建立的数学模型经线性回归模型假设检验,均具有统计学意义(P0.05),回归方程的推断标准误为2.982~5.004cm,相关系数为0.370~0.779,复相关系数为0.533~0.834。对每组相关系数、复相关系数最高的方程进行回代检验,其中A组的y=100.33+1.489 x3-0.548 x6+0.772 x9+0.058 x12+0.645 x15的准确率最高,为80.6%(±1SE)、100%(±2SE)。结论本研究建立的数学模型适用于推断四川汉族女性身高。     

Abusive Pediatric Thoracolumbar Fracture Due to Forced Hyperextension: Case Report,Biomechanical Considerations,and Review of the Literature

Pediatric thoracolumbar fractures are rare due to the physiological differences which afford greater resilience to the immature spine. Most pediatric thoracolumbar fractures occur as the result of high energy trauma, such as motor vehicle accidents, and modes of reasonable accidental injuries are limited by age and developmental capabilities of the child. These fractures can occur as the result of inflicted blunt force trauma and child abuse, and in most cases, the mechanism of injury to the spine is not known. We report the death of a 29-month-old man due to blunt force trauma to the back and forced hyperextension of the thoracolumbar spine causing fracture of the fourth lumbar (L4) vertebral body. A complete forensic examination revealed a previous healing fracture of the anterior aspect of the L4 vertebral body, with acute disruption of the anterior longitudinal ligament overlying the fracture site, complete fracture of the vertebral body, and fatal retroperitoneal hemorrhage. We present a review of the biomechanical considerations of the pediatric spine, a survey of pediatric spinal fractures, and a review of the literature on pediatric abusive thoracolumbar fractures. In this case, there was never a provided explanation for how the injury occurred; however, understanding the biomechanics of the pediatric spine allowed for the determination of the mechanism, force required to produce this specific pattern of abusive spinal injury, and the manner of death.     

火针治疗腰椎间盘突出症后期下肢麻木36例

目的 观察火针疗法对腰椎间盘突出症后期下肢麻木的临床疗效。方法 将68例腰椎间盘突出症后期下肢麻木患者随机分为观察组和对照组，观察组36例，对照组32例。观察组采用电针加火针治疗，对照组采用电针治疗。结果 观察组愈显率显著高于对照组(P<0.01)；两组总有效率比较，差异无统计学意义（P＞0.05）。结论 火针疗法治疗腰椎间盘突出症后期下肢麻木的疗效优于单纯电针疗法，能显著提高下肢麻木的治愈率和显效率。     

Skeletal identification by radiographic comparison: blind tests of a morphoscopic method using antemortem chest radiographs

This study investigated the value of antemortem (AM) and postmortem (PM) radiographs of the claviculae and C3-T4 vertebrae to identify skeletons of missing U.S. soldiers from past military operations. In total, 12 field-recovered skeletons and AM chest radiographs of 1460 individuals were used. For each skeleton, examiners analyzed an array of AM chest radiographs (up to 1000 individuals) and attempted to identify the correct PM/AM radiographic match. When examiners were able to compare all images within a single test, only true-positive identifications were made. When AM radiographs were presented one-at-a-time, in sequential order, and without examiners having knowledge of array size, erroneous identifications resulted but they were almost exclusively made by untrained examiners (accuracy = 35% vs. 90% for trained examiners). This study demonstrates the value of chest radiographs for the identification of disarticulated and even eroded skeletons, but only when methods are wielded by trained examiners.     

Sex Determination Using the Second Cervical Vertebra—A Test of the Method*

Abstract: Sex is one of the critical questions addressed when unidentified skeletal remains are discovered in forensic or archeological contexts. Continuous testing and re‐evaluation of existing techniques is essential to improve accuracy and precision. The Wescott (J Forensic Sci 2000; 45 (2):462–6) method of sex determination from dimensions of the second cervical vertebra was blind‐tested on 153 adult individuals from the Spitalfields documented collection of human skeletal remains held at the Natural History Museum, London. Significant sex differences were determined for all dimensions measured (independent two‐sample t‐test, p < 0.05–0.001). The discriminant functions developed by Wescott were shown to have an overall accuracy of classification of 76.99%. Using stepwise discriminant analysis, a discriminant function based on the Spitalfields data correctly classified sex in 83.3% of individuals and was able to classify males and females with equal accuracy. Additional discriminant functions are presented for use in instances where preservation of the second cervical vertebra is poor.     

中国汉族女性腰椎的身高推断

测量中国汉族女性腰椎,建立腰椎推断身高的方法。按人体骨骼测量方法,对第一至第五腰椎的10项指标进行测量,并将各腰椎的测量数据与身高进行相关分析,建立中国汉族女性腰椎推断身高的回归方程。获得的推断身高的5个回归方程,其相关系数(r)和标准差(s)分别为 r_1=0.751,s=45.0171;r_2=0.698,s=48.2804;r_3=0.758,s=43.3508;r_4=0.497,s=56.0890;r_5=0.606,s=53.3158。本研究建立的方法误差小,可以用于中国汉族女性腰椎的身高推断。     

天灸治疗腰椎退行性骨关节炎30例

目的 观察天灸治疗腰椎退行性骨关节炎的疗效。方法 将60例腰椎退行性骨关节炎患者随机分为治疗组和对照组,分别采用天灸疗法或假天灸疗法。观察治疗前后Oswestry功能障碍指数（Oswestry disability index,ODI）、视觉模拟评分(visual analogue scale,VAS)。结果 治疗组在降低ODI和VAS方面显著优于对照组（P<0.01）。结论 天灸能改善腰椎退行性骨关节炎的功能障碍及缓解疼痛,简便易行。