{"title":"Anatomical structures of the obturator foramen and its importance for pelvic interventıons.","authors":"Ozden Bedre Duygu, Figen Govsa","doi":"10.1007/s00276-025-03661-5","DOIUrl":"https://doi.org/10.1007/s00276-025-03661-5","url":null,"abstract":"<p><strong>Background: </strong>In clinical scenarios such as pelvic fractures, damage to the obturator neurovascular bundle, obturator neuropraxia, and mesh placement in patients with incontinence, preserving the anatomical structures related to the obturator foramen (OF) is crucial. This study aims to investigate the anatomical variations of the OF as a guide for identifying failure criteria and improving success parameters in clinical practice.</p><p><strong>Methods: </strong>The OFs of one hundred adult dry pelvic bones were examined. Measurements were evaluated using ImageJ software. The morphology of the OF and the presence of bony projections on the inner surface of the foramen were assessed.</p><p><strong>Results: </strong>The anterior-posterior length was 5.24 ± 0.8 cm on the right and 5.17 ± 0.87 cm on the left. The superior-inferior length was 4.69 ± 1.83 cm on the right and 4.66 ± 1.69 cm on the left. The anterior-posterior vertical angle was 98.21 ± 9.95° on the right and 98.48 ± 13.9° on the left; the superior-inferior horizontal angle was 90.7 ± 10.95° on the right and 97.56 ± 9.42° on the left. The OF was categorized into six distinct types: quadrilateral (23%), ellipsoid (22%), and oval (17%). The ellipsoid-type OF showed a greater anterior-posterior length compared to the other types, while the triangular-type OF exhibited a greater symphysis pubis length. Notably, bony projections on the anterior edge of the inner surface of the OF were observed in 33% of cases. Additionally, bony projections on the posterior edge of the OF were described for the first time.</p><p><strong>Conclusion: </strong>In cases where OF is narrow and variable, and where bony projections are present on its inner surface, performing an osteotomy may help protect the obturator neurovascular bundle.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"163"},"PeriodicalIF":1.4,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mugurel Constantin Rusu, Răzvan Costin Tudose, Alexandra Diana Vrapciu
{"title":"The parapharyngeal vein-an accessory communication between the middle cerebral veins and the internal jugular vein: a case report.","authors":"Mugurel Constantin Rusu, Răzvan Costin Tudose, Alexandra Diana Vrapciu","doi":"10.1007/s00276-025-03676-y","DOIUrl":"10.1007/s00276-025-03676-y","url":null,"abstract":"<p><strong>Purpose: </strong>The superficial middle cerebral vein (SMCV) typically drains into the cavernous sinus, which, in turn, connects to the pterygoid venous plexus via a sphenoidal emissary vein. The latter may course through the foramen ovale. The pterygoid plexus drains in most cases into the retromandibular and facial veins. A peculiar SMCV drainage pathway to the internal jugular vein (IJV) via a parapharyngeal vein was found here.</p><p><strong>Method: </strong>The anatomic variant reported here was identified by carefully reviewing the archived CT angiogram in a 68-year-old male case.</p><p><strong>Results: </strong>A double SMCV was found on the right side. The resulting common SMCV trunk passed laterally to the foramen rotundum to empty into the cavernous sinus. A sphenoidal emissary vein joined it, which continued inferiorly through the foramen ovale to the pterygoid plexus. This plexus was connected to a reservoir on the inner side of the lateral pterygoid plate from which a fenestrated parapharyngeal vein left. It had two primary fenestrations, and the proximal one had a fenestrated arm. It reached inferiorly and turned around the external carotid artery. At that level, it received two tributaries: first, the superior thyroid vein and then, the facial vein. The resulting facial-parapharyngeal trunk ended in the IJV. These veins and the carotid arteries, deep to them, were hidden beneath the submandibular gland. The right maxillary vein and the anterior branch of the retromandibular vein were absent.</p><p><strong>Conclusion: </strong>The parapharyngeal vein may be a direct drainage pathway for the SMCV and the pterygoid plexus. It should therefore be acknowledged and spared during various surgical approaches.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"162"},"PeriodicalIF":1.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A rare variation of five major vessels arising from the aortic arch with an absence of brachiocephalic trunk.","authors":"B R Omotoso, R Harrichandparsad, L Lazarus","doi":"10.1007/s00276-025-03674-0","DOIUrl":"10.1007/s00276-025-03674-0","url":null,"abstract":"<p><p>The most common variations of the aortic arch branching pattern usually involve the distance between the vessels arising from it and their dimensions. Changes in the number of vessels originating from the aortic arch, ranging from one to four or more major vessels instead of the classical three vessels as independent branches, are uncommon. Incidents of branching patterns involving four independent vessels arising from the aortic arch are rare, and reports of five or six independent vessels are extremely rare. We report on a case of an absent brachiocephalic trunk associated with an aberrant right subclavian artery and five distinct major vessels arising directly from the aortic arch in a South African male. Although most congenital vascular variations are incidental findings on angiographic images, some have also been associated with cerebrovascular diseases such as cerebral aneurysms. In addition, knowledge of these rare variations is of diagnostic importance as their presence may increase the difficulty and alter the specificity of vascular procedures performed using endovascular and open techniques.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"161"},"PeriodicalIF":1.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Involvement of the sinuvertebral nerve in the treatment of chronic low back pain through dorsal root ganglion neurostimulation: an anatomical study.","authors":"Stéphanie Ravaillault, Edouard Samarut, Stéphane Ploteau, Antoine Hamel, Cyrille Decante, Alexis Moles, Céline Salaud","doi":"10.1007/s00276-025-03671-3","DOIUrl":"https://doi.org/10.1007/s00276-025-03671-3","url":null,"abstract":"<p><strong>Objective: </strong>Due to the anatomical proximity of the SVN to the dorsal root ganglion (DRG), several authors have highlighted the potential benefits of DRG stimulation in the management of chronic low back pain. However, the optimal vertebral level for electrode implantation remains debated. To determine the relevance of stimulating the sinuvertebral nerve (SVN) in the management of chronic low back pain and the most appropriate vertebral level for the implantation of this type of electrode.</p><p><strong>Methods: </strong>We dissected the thoraco-lumbar spine (T12 to L5) of six anatomical specimens to highlight the path, innervation areas, and various branches of the SVN.</p><p><strong>Results: </strong>We confirmed that the SVN innervates the posterior third of the intervertebral discs (IVD), the posterior longitudinal ligament (PLL), the anterior face of the dural sheath, the periosteum, the walls of the basivertebral veins, the segmental arteries, and their branches. Moreover, we demonstrated the dual somatic and sympathetic roles of the SVN. Finally, we observed an intra- and intersegmental network covering several adjacent vertebral levels. The superficial network of the SVN converges towards the L2 spinal nerve (SN).</p><p><strong>Conclusion: </strong>We demonstrated the anatomical rationale for stimulating the DRG through rigorous anatomical dissection of the SVN. The most relevant indication appears to be for Persistant Spinal Pain Syndrome (PSPS) type 2 patients, with electrode implantation at the L2 vertebral level bilaterally.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"160"},"PeriodicalIF":1.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mbalentle Madolo, Geney Gunston, Stuart More, Kentse Mpolokeng
{"title":"An angiographic study on the morphometry of the anterior communicating artery complex- a South African sample.","authors":"Mbalentle Madolo, Geney Gunston, Stuart More, Kentse Mpolokeng","doi":"10.1007/s00276-025-03670-4","DOIUrl":"10.1007/s00276-025-03670-4","url":null,"abstract":"<p><strong>Purpose: </strong>The anterior communicating artery complex (ACAC) comprises the A1 and A2 segments of the anterior cerebral artery (ACA) and the anterior communicating artery (ACoA). It is a common site for aneurysms and variations in anterior cerebral circulation. With ongoing advancements in endovascular intervention, there is an increasing need for detailed anatomical knowledge of the ACAC. This study was conducted to explore the anatomical measurements, including the length and diameter, of the ACAC in a South African population.</p><p><strong>Method: </strong>The study involved the analysis of 200 adult magnetic resonance angiogram (MRA) scans (145 female, 55 male) from Groote Schuur Hospital, Department of Radiology, where the internal length and diameter of ACAC vessels were obtained.</p><p><strong>Results: </strong>The average internal length of the right and left A1 ACA segments was 13.5 (3.48) mm and 12.85 (2.57) mm, respectively. The internal diameter of the right and left ACA was 2.26 (0.45) mm and 2.25 (0.68) mm, respectively. For the A2 ACA, the average internal length for the right A2 ACA was 23.4 (3.94) mm, and the left A2 ACA had an average internal length of 23.7 (3.97) mm. The average internal diameter for the right and left A2 ACA was 2.3 (0.33) mm and 2.37 (0.78) mm, respectively. For ACoA, the average internal length was 1.5 (1.76) mm, and the average diameter was 0.85 (0.91) mm.</p><p><strong>Conclusion: </strong>The morphometric parameters of the ACAC measured in this study were within similar ranges to those reported in previous international and national studies.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"159"},"PeriodicalIF":1.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The use of technical grade chemicals and on-site production of ammonium nitrate: a cost-effective and safer approach to Thiel embalming.","authors":"Napawan Taradolpisut, Wattana Weerachatyanukul, Worawit Suphamungmee, Somluk Asuvapongpatana, Torsak Luanphaisarnnont, Arada Chaiyamoon, Thewarid Berkban, Tyler Halliwell, Tracey Wilkinson, Athikhun Suwannakhan","doi":"10.1007/s00276-025-03672-2","DOIUrl":"https://doi.org/10.1007/s00276-025-03672-2","url":null,"abstract":"<p><strong>Purpose: </strong>While Thiel embalming effectively preserves cadavers in a lifelike and flexible state, its implementation is constrained by high costs and the use of ammonium nitrate, which may be restricted in certain countries due to regulatory controls and safety concerns. This study aims to develop a more economical and safer approach to Thiel embalming by using technical grade chemicals and synthesizing ammonium nitrate on-site and, both overcoming economic barriers to Thiel embalming and addressing regulatory constraints associated with ammonium nitrate.</p><p><strong>Methods: </strong>In the present study, technical grades were used instead of reagent grades. Ammonium nitrate was synthesized through a controlled reaction of nitric acid and ammonium hydroxide under strict safety protocols. The solution was incorporated into Thiel embalming fluids and used for arterial and venous embalming of 28 cadavers at two institutions.</p><p><strong>Results: </strong>The cadavers embalmed using the methods presented in this study were comparable to conventional Thiel-embalmed cadavers, preserving tissue flexibility, color, and structural integrity. The only notable difference was the reduced submersion duration, which was limited to three to four months.and the technique effectively mitigated the hazards of ammonium nitrate storage.</p><p><strong>Conclusion: </strong>The use of technical grade chemicals, combined with on-site production of ammonium nitrate, presents a more cost-effective alternative for Thiel embalming, particularly in regions with stringent regulations, making Thiel embalming more accessible for anatomy departments worldwide.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"157"},"PeriodicalIF":1.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ayla Tekin, Nizameddin Fatih Karamus, Tuncay Çolak
{"title":"Anatomy exam model for the circulatory and respiratory systems using GPT-4: a medical school study.","authors":"Ayla Tekin, Nizameddin Fatih Karamus, Tuncay Çolak","doi":"10.1007/s00276-025-03667-z","DOIUrl":"https://doi.org/10.1007/s00276-025-03667-z","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to evaluate the effectiveness of anatomy multiple-choice questions (MCQs) generated by GPT-4, focused on their methodological appropriateness and alignment with the cognitive levels defined by Bloom's revised taxonomy to enhance assessment.</p><p><strong>Methods: </strong>The assessment questions developed for medical students were created utilizing GPT-4, comprising 240 MCQs organized into subcategories consistent with Bloom's revised taxonomy. When designing prompts to create MCQs, details about the lesson's purpose, learning objectives, and students' prior experiences were included to ensure the questions were contextually appropriate. A set of 30 MCQs was randomly selected from the generated questions for testing. A total of 280 students participated in the examination, which assessed the difficulty index of the MCQs, the item discrimination index, and the overall test difficulty level. Expert anatomists examined the taxonomy accuracy of GPT-4's questions.</p><p><strong>Results: </strong>Students achieved a median score of 50 (range, 36.67-60) points on the test. The test's internal consistency, assessed by KR-20, was 0.737. The average difficulty of the test was 0.5012. Results show difficulty and discrimination indices for each AI-generated question. Expert anatomists' taxonomy-based classifications matched GPT-4's 26.6%. Meanwhile, 80.9% of students found the questions were clear, and 85.8% showed interest in retaking the assessment exam.</p><p><strong>Conclusion: </strong>This study demonstrates GPT-4's significant potential for generating medical education exam questions. While it effectively assesses basic knowledge recall, it fails to sufficiently evaluate higher-order cognitive processes outlined in Bloom's revised taxonomy. Future research should consider alternative methods that combine AI with expert evaluation and specialized multimodal models.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"158"},"PeriodicalIF":1.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Petr Fojtík, Jan Bartoníček, Jan Frühauf, Ondřej Naňka
{"title":"Anatomy and metrics of the medial malleolus.","authors":"Petr Fojtík, Jan Bartoníček, Jan Frühauf, Ondřej Naňka","doi":"10.1007/s00276-025-03669-x","DOIUrl":"https://doi.org/10.1007/s00276-025-03669-x","url":null,"abstract":"","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"156"},"PeriodicalIF":1.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A comprehensive CT analysis of tibial nutrient artery anatomy: identifying critical areas to avoid in orthopedic procedures.","authors":"Nurcan Ercikti, Şeref Barbaros Arik","doi":"10.1007/s00276-025-03656-2","DOIUrl":"https://doi.org/10.1007/s00276-025-03656-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to examine the location, number, course, and diameter of tibial nutrient canals in detail to minimize potential vascular damage during orthopedic interventions such as fracture fixation and bone graft procedures.</p><p><strong>Methods: </strong>A total of 56 dry tibiae were scanned via CT with a slice thickness of 0.75 mm. The number, length, diameter, and location of the nutrient canals relative to the tibial plateau were recorded. Pearson correlation and Mann‒Whitney U tests were conducted to evaluate the relationships between the measured canal parameters and tibial metrics.</p><p><strong>Results: </strong>Fifty-eight nutrient canals were identified. Among these, 98.27% were located within the distal portion of the proximal third or the proximal portion of the middle third of the tibia. The nutrient canals were predominantly concentrated (81.03%) in the posterolateral region, with the remainder distributed among the posterior, posteromedial, and anterolateral surfaces. The findings indicated that \"the region with a high likelihood of encountering a nutrient canal\" extends from approximately 6.96 cm to 22.75 cm along the tibial shaft, spanning a 135°-225° arc.</p><p><strong>Conclusion: </strong>A detailed anatomical understanding of tibial nutrient arteries is essential for preserving blood flow and preventing iatrogenic vascular injuries in orthopedic procedures, particularly during internal fixation and graft applications. Identifying this \"region with high nutrient canal density\" may help reduce nutrient artery injury and promote faster fracture healing.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"155"},"PeriodicalIF":1.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Figen Govsa, Gkionoul Nteli Chatzioglou, Ahmet Bicer, Gokhan Gokmen
{"title":"Anatomy-based computer-assisted evaluation for aesthetic new navel formation.","authors":"Figen Govsa, Gkionoul Nteli Chatzioglou, Ahmet Bicer, Gokhan Gokmen","doi":"10.1007/s00276-025-03646-4","DOIUrl":"https://doi.org/10.1007/s00276-025-03646-4","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the typical position and shape of the umbilicus among young individuals to guide the repositioning of the new umbilicus during abdominoplasty.</p><p><strong>Methods: </strong>Standardized photographs of 63 young volunteers were analyzed to evaluate parameters such as the vertical and horizontal positions, length, ratio, and shape of the umbilicus. The study also established the mathematical relationships between the umbilicus and nearby anatomical structures like the xiphoid process, pubic symphysis, anterior superior iliac spine, iliac crests, and body mass index (BMI) to identify the ideal geometric shapes and positions. In two patients with abdominal skin sagging, abdominoplasty was performed with a new umbilicus designed according to these anatomical measurements.</p><p><strong>Results: </strong>The umbilici were categorized by shape: vertical oval with superior hooding (29%), round (27%), vertical lozenge (21%), and protruded (11%). Ratios between anatomical points were measured, such as the ratio of the distance between the xiphoid process and the upper edge of the umbilicus to the distance between the lower edge of the umbilicus and the symphysis pubis, which was 1.64 ± 0.40. Post-operative evaluation emphasized achieving a xiphoid-umbilicus/pubic symphysis ratio of 1.6:1 for the new umbilicus, with an aesthetically ideal ratio considered to be 1:1. A strong correlation was found between BMI and all umbilical ratios.</p><p><strong>Conclusions: </strong>The most aesthetically pleasing navel position aligns with the golden ratio between xiphoid and umbilicus compared to the umbilicus and abdominal crease. Weight control is also crucial in achieving optimal belly aesthetics.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"154"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}