A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / The paucity of clinical research into the efficacy and effects of the different treatment protocols available for cervical facet syndrome has led to a continued variation in standard care for this condition. The aim of this study was to determine the relative effectiveness of spinal manipulative therapy in conjunction with the administration of a nonsteroidal antiinflammatory drug (NSAID) versus spinal manipulative therapy in conjunction with the administration of a placebo medication in the treatment of cervical facet syndrome. It was hypothesised that treatment with spinal manipulative therapy and NSAIDs over a two week period, with a further four week follow-up period, would be more effective than spinal manipulative therapy and placebo medication in terms of the objective and subjective clinical findings. The study design chosen was that of a double-blind, comparative, clinical trial. Thirty consecutive patients diagnosed with cervical facet syndrome were randomly assigned either to the manipulation and NSAID group or the manipulation and placebo group. The age range of the patients extended from nineteen to fifty-three years. Forty percent of patient occupations in both groups involved work on a computer. Each patient in the NSAID group received 139.5mg of diclofenac free acid a day over five days. The placebo group received the same dosage of similar appearance and taste over the same period. Each group of fifteen patients received treatment three times a week for two weeks. After a follow-up period of four weeks the patients were re-assessed. The patients were assessed by means of obtaining subjective information consisting of three questionnaires: the McGill Short-Form Pain Questionnaire, the Numerical Pain / M

A dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Technikon Natal, 1998. / The purpose of this study was to evaluate the relative effectiveness of adjusting the superior vertebral segment as opposed to adjusting the inferior vertebral segment, of the two vertebral motion segments forming the facet joint responsible for the patient's symptoms and resulting in the diagnosis of facet syndrome, in the treatment of mechanical low back pain. Thirty subjects with mechanical low back pain were screened for facet syndrome and randomly divided into two groups of fifteen. Each patient received spinal manipulation for six treatments over 4 weeks, but the contact vertebra was different for each group. In the one group, contact was taken on the superior of the two vertebrae making up the facet syndrome, whereas contact was taken on the inferior of the two involved vertebrae in the second group. In the 'superior' group, the manipulative thrust was directed in the direction of the motion palpation findings, whereas in the 'inferior' group, the manipulative thrust was directed in the opposite direction to the motion palpation findings of the superior segment. Both groups were evaluated in terms of subjective and objective clinical findings by making use of questionnaires (Oswestry Back Pain and Disability Index; Numerical Pain Rating Scale-1 01; Short Form McGill) and goniometer measurements respectively. / M

The aim of this project was to develop robust interactive computer methods for measuring the shape and movement of the lumbar spine vertebrae from lateral radiographs of the spine. In order to achieve this aim, two software packages were written - the Aberdeen Vertebral Morphometry System (AVMS) and the Aberdeen Spinal Videofluoroscopy System (ASVS). AVMS was designed to analyse static images from dual energy x-ray absorptiometry (DXA) imaging densitometers. Comparative precision tests of the ability of AVMS software and Lunar EXPERT-XL software to measure vertebral height were undertaken using four vertebrae from the same lateral spine image (male, 67 years). Two of the vertebrae in this image were abnormal and two were normal. It was concluded that AVMS had higher precision when measuring abnormal and normal vertebrae. The effects of axial rotation and lateral bending, which lead to movement out of the sagittal plane, were investigated by generating a three-dimensional computer model of two adjacent vertebrae and projecting it on to the sagittal plane. The projected model was measured as if it were a radiograph, allowing the effects of out-of-plane movement and errors in reference point placement to be calculated. ASVS was used to acquire and analyse a sequence of images of the spine in motion obtained using videofluoroscopy and incorporated the findings of the computer modelling work. A clinical study for the measurement of intervertebral motion using ASVS during flexion-extension was organised and seven subjects suffering from severe lower back pain were recruited. Analysis of the image sequences using the computerised measurement system in ASVS revealed the apparent effect of analgesia/sedative on the shape and size of centroidal trajectories of vertebrae, and the differences in trajectory shape between subjects. It was concluded that ASVS was able to quantify spinal motion at a minimal radiation dose to the subject.

The thoracic skeletal morphology of homininae is poorly known and understood. As a result of the representative fossil record of ribs and vertebrae being rare, distorted, fragmentary or unrecognised even when recovered, very little is known about the variability of rib and vertebral morphology when compared to the other cranial and postcranial elements in this lineage. Yet the costal skeleton forms a substantial part of the postcranial skeleton and thus ribs and vertebrae are therefore potentially numerous in the fossil record; but in comparison with other skeletal elements, and for the reasons mentioned above, very little is known about vertebrate and especially hominin rib morphology. The assessment of the structure of the thoracic skeletal elements and its evolutionary and ecological significance, particularly in the Homininae, poses a challenge but is still important as the shape and form of the rib cage has numerous functional and behavioural implications. The present study analysed the ribs of selected primate and non-primate mammalian species by examining fifteen variables, seven indices and eight osteological non-metric features. These observations and measurements were compared to ribs found in the fossil record in order to determine if there are any structural correlates between the extant and the extinct hominin and mammalian species and in order to create a template for the identification of hominin ribs within an abundant and diverse mammalian assemblage. The results suggest that the 1st rib, due to its unique morphology, may be considered most diagnostic in differentiating various taxa. In addition, a template for the morphology of the proximal end of the first rib has been created to be used for both the general as well as the specific identification of fossilised fragments, and to determine thoracic shape. The recently recovered costal elements of the Australopithecus sediba fossils were also examined as one of the most abundant assemblages of the elements in the early hominin record in order to add to our understanding of the morphology, and evolution of this poorly known area of hominin anatomy. The thorax of Australopithecus sediba demonstrates a medio-laterally narrow, ape-like upper thoracic shape, which is different from the broad upper thorax of Homo that has been associated with to the locomotor pattern of endurance walking and running. The lower thorax, however, is less laterally-flared than that of apes, and more closely approximates the morphology found in humans. This indicates a mosaic morphology of the thorax during the human evolutionary linage.

The frequency of variations in nine morphological features of the cervical column in a South African (S.A.) black and white example of human skeletons was investigated to determine whether there Was a greater degree of morphological variability in the black as compared with the white sample. These findings were compared with other population groups. Intertribal, sex and side differences were examined, The possible aetiology of these variations was explored. [Abbreviated abstract. Open document to view full version] / GR 2016

Thesis--Auburn University, 2006. / Abstract. Vita. Includes bibliographic references (p.108-111, etc.).

Thesis (Ph.D.)--Kent State University, 2008. / Title from PDF t.p. (viewed Oct. 8, 2009). Advisor: C. Owen Lovejoy. Keywords: lumbar transverse process; vertebral evolution Includes bibliographical references (p. 214-221).

Intervertebral disc(IVD) degeneration is associated with low back pain (LBP).Despite the endplates are located adjacent to the IVD, the phenotypes of endplate and vertebral bone marrow changes remain unclear. The objective of this study is to assess the prevalence and the associated determinants of these phenotypes of the lumbar spine. 2449 Southern Chinese subjects (aged 10 –88 years) undergone sagittal T2-weighted magnetic resonance imaging (MRI)examination to assess the presence of endplate and vertebral bone marrow changes including Schmorl’s nodes (SN) and Modic changes (MC),respectively, and scored for additional radiographic features over the lumbar spine. Subjects’ demographics, clinical profile, and functional status were assessed by means of standardized questionnaires. Anovel6-domain SN morphological classification based on MRI was developed to further analyze the characteristics of SN and its association with disc degeneration (DD). The prevalence of SN was 16.4%. Males, taller and heavier individuals had a significantly increased likelihood of SN. Overall presence of SN was age-independent, but was significantly associated with DD, and linearly correlated with increase in severity of DD. SN were particularly associated with severe DD at the upper two lumbar levels (L1/2 – L2/3). Based on the SN classification system, specific SN characteristics and endplate linkage patterns were found. Of these, two SN types were identified:“Typical SN” and “Atypical SN”. “Typical SN” were those smaller size SN with various shapes that were frequently located at caudal endplates of L1/2–L3/4disc levels. One variant of “Atypical SN” were those rectangular shape SN, which predominantly located at the posterior region of the rostral endplates of L1/2–L2/3disc levels. The other variant of “Atypical SN” was larger size SN with irregular shape that frequently presented at the L4/5endplates, they were also likely to be associated with marrow changes. Despite “Atypical SN” only entailed 8.3% of all identified SN, they were associated with increased severity of DD than “Typical SN”. Although the overall prevalence of MC among Southern Chinese was low (5.8%), after adjustments for other confounding factors, the presence of MC was associated with the presence and severity of LBP. Interestingly, the determinants of MC at upper (L1/2 – L3/4) and lower (L4/5 – L5/S1) lumbar showed distinct difference. The presence of MC at upper lumbar levels was only associated with the disc integrity only (i.e. the presence of disc displacement, and DD score), while the presence of MC at the lower levels, apart from the disc integrity, was also associated with increasing age, the presence of SN, smoking and obesity status. This study is the largest MRI study assessing the phenotypes of endplate and vertebral bone marrow changes in-vivo. The prevalence and distribution of SN and MC vary throughout the lumbar spine, and there are level and region-specific variations regarding these phenotypes. Determinants of SN and MC may be similar but do vary, suggesting distinct etiological factors. Findings of this study broaden the understanding of the various phenotypes of the lumbar spine and its association with DD. / published_or_final_version / Orthopaedics and Traumatology / Doctoral / Doctor of Philosophy

Thesis (M.App.Sc. (Physio))--University of South Australia, 1998.

Thesis (MAppSc in Physiotherapy) -- University of South Australia, 1998