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Variations of Fissures and Lobes In Human Lungs-A Multicentric Cadaveric Study from West Bengal, India |
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Enakshi Ghosh, Rituparna Basu, Anjana Dhur, Anindya Roy, Hironmoy Roy, Amitava Biswas 1. Assistant Professor, Department of Anatomy, Burdwan Medical College, Burdwan, India. 2. Assistant Professor, Department of Anatomy, Bankura Sammilani Medical College, Bankura, West Bengal, India. 3. Assistant Professor, Department of Anatomy, Murshidabad Medical College, Murshidabad, India. 4. Assistant Professor, Department of Physiology, R.G. Kar Medical College, Kolkata, West Bengal, India.5. Assistant Professor, Department of Anatomy, North Bengal Medical College, Darjeeling, India. 6. Consultant, Department of Neurosciences, Park Clinic, Kolkata, West Bengal, India. |
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Correspondence Address : Enakshi Ghosh, Rituparna Basu, Anjana Dhur, Anindya Roy, Hironmoy Roy, Amitava Biswas, Dr. Enakshi Ghosh, 1-B, Surji Dutta Lane, P.O. Beadon Street, Kolkata-700006, West Bengal, India. Phone: +91 8902494142 E-mail: drenakshighosh@gmail.com |
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| ABSTRACT |  | ||||||||||||||||||||||||||
: Morphometry of body and neural arch of lumbar vertebrae is very crucial in manufacturing screws, interspinous implants as well as preoperative planning of surgeries involving dorsolumbar spine. Aim: To determine various dimensions of typical and atypical lumbar vertebrae. Materials and Methods: A descriptive osteological study was carried out which included 66 intact adult dry human lumbar vertebrae (53 typical and 13 atypical) which were free of any deformity or pathological features. All the 53 typical vertebrae were randomly obtained. The following parameters were measured with slide callipers- superior transverse diameter and superior antero-posterior diameters of vertebral foramen; transverse diameter, antero-posterior diameter and anterior height of vertebral body; width, height of pedicles; interpedicular distance; maximum thickness of lamina; length of transverse process; maximum length, maximum height and maximum central thickness of spinous process. The data was tabulated and analysed using Microsoft Excel software. Mean and standard deviation was calculated for each parameter. Unpaired t-test was applied and p-value was derived for parameters like width and height of pedicles, thickness of lamina and length of transverse process. The p-value<0.05 were considered as significant. Results: The vertebral foramen (superior transverse diameter- 20.41±2.54 mm, superior antero-posterior diameter- 13.3±2.04 mm); vertebral body (transverse diameter- 44.43±5.91 mm, antero-posterior diameter- 30.17±3.19 mm, anterior height- 24.01±1.84 mm); pedicle (width- 10.85±3.94 mm on left side and 11.04±4.01 mm on right side, height- 13.84±4.01 mm on left side and 13.8±1.93 mm on right side, interpedicular distance- 29.17±5.06 mm); lamina (thickness- 6.6±1.36 mm on left side and 6.85±1.34 mm on right side); transverse process (length- 20.94±4.01 mm on left side and 21.51±4.5 mm on right side); spinous process (maximum length- 26.01±3.73 mm, maximum height- 19.92±4.03 mm, maximum central thickness- 6.42±1.41 mm). The mean transverse diameter and antero-posterior diameter of vertebral foramen of atypical lumbar vertebrae were higher than those of the typical lumbar vertebrae and these differences were significant (p-value of 0.0001 for transverse diameter and p-value of 0.005 for antero-posterior diameter). Conclusion: Most of the parameters of atypical lumbar vertebrae were found to be more compared to those of typical lumbar vertebrae. This inference should be kept in mind during fixation of lumbar inter-spinous implants, designing of pedicular screws and spinal grafting. | |||||||||||||||||||||||||||
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| Keywords : Lungs, Fissures, Lobes, Variations | |||||||||||||||||||||||||||
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| INTRODUCTION |
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The lungs are the essential organs of respiration which are situated within the thoracic cavity on either side of the heart & other mediastinal contents. Each lung is approximately half conical in shape & presents an apex, base, three borders & two surfaces. In addition, the right lung is divided into superior, middle & inferior lobes by an oblique fissure (1). The oblique fissure cuts the vertebral border of both lungs at the level of 4th or 5th thoracic spine. Traced downwards on the medial surface it ends above the hilum; traced downwards on the costal surface, it will be found to continue across the diaphragmatic surface & turns upwards on to the medial surface to end just below the lower end of the hilum. Horizontal fissure, seen only in the right lung begins laterally at the oblique fissure & runs almost transversely across the costal surface to the anterior margin & around the margin back to the hilum (2). The fissures facilitate the movement of the lobes in relation to one another, which accommodates the greater distension & movement of the lower lobes during respiration. Thus, they help in a more uniform expansion of the whole lung (2). Other than the normal anatomy, different variations in the fissural patterns are observed in the form of incomplete fissures where there is fusion of lung parenchyma between the lobes & absent fissures or accessory fissures of varying depth, delimiting anomalous lobes corresponding to normal bronchopulmonary segments (3). Since these fissures delimit the lobes & thus are needed for locating bronchopulmonary segments, knowledge of their position is necessary both anatomically as well as clinically for planning lobectomies & surgical resections & also in the interpretation of radiological images. Hence, this case series was carried out to gain further insight into the fissural pattern of human lungs. Objective To find out the anomalous fissures and lobes along with their patterns, in human lungs; collected from cadavers, in different medical colleges of West Bengal, India. | |||||||||||||||||||||||||||
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| TABLES AND FIGURES |
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Original article / research
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