Background/Objective: Low back pain is still a challenge in medicine. Numerous factors can influence this phenomenon; of which congenital anomalies such as Lumbosacral Transitional Vertebra (LSTV) that might cause degenerative changes is one. The purpose of this study was to assess pathological findings in adjacent Vertebra in two groups of patients. Patients and Methods: Considering plain AP Lumbar spine x-ray, 91 cases were allocated in LSTV and 108 non-LSTV groups. In Lumbar MRI, disk degeneration, disk herniation, anterior and posterior osteophytes, facet joint hypertrophy, ligamentum flavum hypertrophy and disk height were assessed in both groups in L1-L2, L2-L3, L3-L4, L4-L5 (TV), L5 (TV)-S1 levels.Results: Generally, by reaching level L4-L5 (TV), frequencies of all variables increase and they drop in the level L5 (TV)-S1 in both groups, regardless of LSTV existence. The frequency of disk degeneration on level L4-L5 (TV) in the group with and without LSTV was 81.3% and 75% (P=0.28). In level L5 (TV)-S1, the frequency of disk herniation between these two groups was 34.1% and 56.5% (P=0.02) and the mean value of disk height was 7.4±2.6mm and 9.5±2.27mm (P < 0.001). Comparison of the mean difference of disk degeneration and herniation between two groups was statistically or clinically significant (0.07 and 0.006). We divided patients in both groups into three different age groups (age≤30y, 30yConclusion: It seems that LSTV increases disk degeneration and hernation in the disk above it and preserves the lower disk from these events and its role is more significant when the patient is young.

Pheochromocytoma is a rare neoplasm with increased production of catecholamines and high blood pressure. These tumors are in chromatin cells group.10% of these tumors are out of Adrenal gland and have negative for chromatin and are named Paraganglioma. Less of 10% of these tumors are malignant and metastasis is the only reliable indicator of malignancy. (Metastasis to lymph node, liver - lung and bone) Our patient was a 34-years-old man with high blood pressure and unilateral nephrectomy that visit us for Lower Back Pain (LBP) with radicular pain in the right foot. After MRI in L4 and L5 one hyposignallesion was considered and in biopsy under CT scan guide from Vertebra (pheochromocytoma out of Adrenal gland) Paraganglioma was reported. So in LBP with regional metastatic lesion and high blood pressure we must also consider pheochromocytoma in differential diagnosis.

Objective: In this paper, finite element model of the L4 Vertebra subjected to combination of compression and flexion loading in isotropic and anisotropic cases is investigated.Methods: In both cases, the Vertebra is considered homogeneous. Also, the body of Vertebra is divided to cancellous and cortical sections in anisotropic model, but the process is assumed isotropic such as isotropic model. The maximum Von Mises stress on the fourth Lumbar Vertebrae is obtained. Also, the stress intensity factor is analyzed with placing a small crack on the critical region of the model from view point of fracture mechanics. Furthermore, the required force for the fracture of fourth Lumbar Vertebrae is obtained through increasing the applied force for assumed model.Results: The results show that the highest stress value and its position is 7.237MPa in the upper pedicle region for anisotropic property of Vertebrae. At the end of this article, stress intensity factors in different aspect ratios of crack for anisotropic Vertebrae under combination of flexion and compression loading are plotted.

The purpose of present research is the effect of complex kinesiotherapy on physical rehabilitation of patients who suffer from osteochondrosis in the hospitalized patients. Subjects included 30(18 female, 12 male) voluntary patients who aged between 23 and 60. They were randomly divided into two groups: Control group (n1 = 15) and experimental group (n2 =15). Patients were selected from 2000 to 2002 in Moscow hospital No 15. Two groups were surveyed before and after research and finally it was found out that patients in control group were improving better than the patients in experimental group in pain feeling in the Lumbar, range of motion in the joints of lower limbs, range of motion in the Vertebra, range of depression, self-confidence, mood and activity, strength through measurement of muscle testing. Rehabilitation of patients withosteochondrosis in the Lumbar division of the Vertebra requires that in designing kinesiotherapy in different steps of physical rehabilitation (acute, sub acute, restoration), we apply the complex method on exercise therapy, massage and hydrotherapy with regard to acuteness of illness and patients characteristics. Since the use of kinesiotherapy in sub acute phase along with other therapy methods such as pharmacotherapy and physiotherapy not only causes acceleration of patients improvement but also leads to a decrease in pain feeling and the strength of different muscles such as lower limbs, dorsal area and abdomen than patients who don't use complex method. In addition, the application of complex method causes an increase in the range of motion and the improvements of the flexibility factor in lower limbs and in patients suffering from osteochondrosis in the Lumbar division of the Vertebra.

Introduction: Cement augmentation in Vertebrae is used to promote mechanical strength after spinal fracture and recently vertebroplasty gaining popularity as a treatment for patients. The numerical simulation could be helpful to enhance the quality of treatments such as vertebroplasty via exact modeling of the Lumbar spine. Materials and Methods: In this study, a three-dimensional finite element model created from CT images of L1-L3. According to clinical observation and recent studies, we consider that L2 augmented with two different volumes in 10 different distributions. Loadings were assumed to be pure momentum which applied in three anatomical directions (axial rotation, flexion, and lateral bending). Results: Our results were validated with experimental data which shows segments range of motion, ligaments forces, and intradiscal pressure had good agreement with our results. Cement augmentation increases max Von Misses stress in L2 cancellous bone and Increment in Cement volume has the same result. Cement augmentation increases L1-L2 intradiscal pressure. Cement augmentation decreases segments range of motion. Finally, Cement augmentation increases total stiffness of model. Conclusion: Taken together, vertebroplasty as a well-known method to treat the fractured Vertebra, could be optimized to enhance patients' range of motion and decrease the complication of treatment.

Background – In the cervical spine there is a relation between spinal canal dimension and the occurrence of neurologic sequelae after trauma, while at the first Lumbar Vertebra (L 1) this relation has not been conclusively established. In this study we aimed to investigate such an association.Methods– One-hundred patients with L1 burst fracture, admitted to the Department of Neurosurgery, Kerman University of Medical Sciences between 1995 and 2002 (50 paraplegic and 50 without neurologic deficit) were included in the study.Using computerized tomography (CT) scanning, the ratio of sagittal-to-transverse diameter (S/T ratio) and the cross-sectional area (CSA) of the spinal canal at L1 were measured. Statistical analysis, comparing those patients with neurologic deficit to those without, was performed using a t -test, and a simple linear regression model between S/T ratio and CSA was designed.Results– In paraplegic patients, the S/T ratio was 39.08 ± 6.63 (mean ± SD) and CSA was 309.92 ± 22.48 mm2. In neurologically intact patients, S/T ratio was 48.46 ± 6.43 and CSA was 349.34 ± 22.35 mm2. The S/T diameter ratio and CSA were significantly smaller in paraplegic patients than in those without a neurologic deficit (p<0.05 for both). However, a simple Pearson bivariate correlation showed that the relation between S/T ratio and CSA of the spinal canal was not significant (p> 0.05).Conclusion– CT parameters of spinal canal dimensions correlated with severe neurologic deficit (paraplegia) in L1 burst fracture with retropulsed bone fragments in the spinal canal, but these parameters did not significantly relate to each other. 

BACKGROUND AND OBJECTIVE: Having the correct anatomical points and the size of the pedicle dimension is necessary to minimize neurological complications. Currently, the gold standard for spinal fusion is the use of pedicle screws. In this method, the pedicle screw should be placed in its ideal position. Given the importance of this topic, the present study was performed to determine the dimensions of right and left pedicle by computed tomography (CT) scan in three axial, coronal and sagittal planes based on gender in Fars-native ethnic group. METHODS: This cross-sectional study was performed on 40 patients (20 females and 20 males aged 18 – 45 years) from Fars-native ethnic group. The average height for males was 165 to 180 cm and for females between 165 and 175 cm. Healthy Vertebrae were selected in people who referred to a CT scan unit with symptoms of spinal pain or trauma. Determination of height, length and width of right and left pedicle of Lumbar Vertebrae in axial, coronal and sagittal view in 1. 5 mm sections was performed by CT scan. FINDINGS: Mean and standard deviation of height (1. 458± 0. 141), width (0. 788± 0. 173), and length (1. 248± 0. 195) of pedicle in men (based on millimeter) was significantly higher compared to mean and standard deviation of height (1. 268± 0. 140), width (0. 618± 0. 148), and length (1. 08± 0. 174) in women (p<0. 05). CONCLUSION: The results of this study showed that gender affects the dimensions of Lumbar Vertebral pedicle.

Introduction: The aim of this retrospective study was to differentiate between small fifth Lumbar (L5) Vertebral body diameter as normal variant with spondylolisthesis.Materials and Methods: Three radiologists reviewed 2000 lumbosacral MRIs of different patients who were referred for any problems to a imaging center during 3 months. The patients with a previous history of lumbosacral surgery and congenital Lumbar anomalies were excluded from the study.Results: In these 2000 lumbosacral MRIs, 87 cases showed anterior stepping of the posterior wall of L5 in comparison with posterior wall of L4 (These cases can be reported as spondylolisthesis or pseudospondylolisthesis in MRI reports). 46 cases (2.3%) show true spondylolisthesis and 41 cases (2.05 %) show small anteroposterior diameter of the body of L5 in comparison with L4.Conclusion: Small AP diameter of L5 is a normal variant in about 2% of lumbosacral MRIs, which can mimic spondylolisthesis.

Dear Editor-in-Chief: Low back pain (LBP) is the persistent pain of Lumbar muscle and Vertebra more than three days regardless of the existence of radiating pain to lower limbs (1). The symptom of LBP is caused by the hypokinesia of muscle and tendon supporting the Lumbar Vertebra and, in turn, Lumbar muscle dystrophy caused by the inactivity of the Lumbar Vertebra leads to aggravated Lumbar pain and pain recurrence (2)...