Aortic thoracic vertebral impression = bone erosion?

?HA HA HA

Heidelberg impression from the last 15 minutes of this weekend on one table...

During economic downturn certainly, but always...one rule : invest in yourselves.?

What we know, what we think we know, consists of so many moving parts...so the outcome is always dubious, except with natural principles and their philosophical consequences.

Thus, it is never too late to start with philosophy, most certainly in times when, the economical environment is turning dark grey.

Moreover, philosophy does not have to be: "learning a million quotes from long dead philosophers by heart" rather turn it into the living active verb: "philosophizing".

Reasoning from the facts in front of your senses as nature displays them, without judgement.

As Plato, an old Greek philosopher, once used the allegory: "We all sit in a cave and see the shadow-play on the cave's wall, while reality is happening outside the cave".

Don't be lured or worse, lure yourselves by the moving shadows on the cave wall...on the contrary, step out into nature and see its principles at work, displaying everywhere. Or as A.T. Still said: Osteopathy is found in nature, osteopathy is founded on nature, Osteopathy is nature....Observe and reason.

This weekend in Heidelberg University...

This weekend in Heidelberg University on the last day of the dissection course, within less than the very last half hour: the thorax is completely opened and almost emptied, the only parts left inside are the vascular components of the aorta and Azygos - hemiazygos system, ductus thoracicus and the autonomous ganglia chain.

Two of the Evost Fellows, are regarding this situation with satisfaction and at the same time regret, as there is not enough time left to fiddle with the last details...

As the Romans used to say: "Post co?tum omni animale triste est" After the climax, every animal is sad, filled with a regret that it is over...

Sensing and seeing their state, I joined them as my last students had just left the room.

And told them cut the aorta loose, open it and clean the clothed blood-rests out of it, and take a closer look on the inside...

As the lady (S) is the most active of the two, she starts immediately doing this, happy to do something meaningful with her last minutes in the dissection room, the other one (G) is still staring with some regret and sadness at the long "Aortic impression on the vertebrae and discs".

Sensing this state, I asked him a last mental effort revival: " G., do you see the aortic impression that has, according to medical literature, eroded its way in the spine?"

'Yes, obviously', is G's response.

I reply, "put two fingers in it and follow it down to the diaphragm, palpate it, to ascertain yourself it is really there visible and palpable"

He does it and says 'yes, it is obvious and clear'

My response, "it is not there, you just lured yourself, why ?"

His gaze shows a spark of ignition as it turns into a questioning - reasoning look, and he says: ' you mean that, what we are all three seeing and that I just palpated, is not there, is that what you are saying?'

"Yep" comes my response, "you are seeing the shadow reflection on the cave wall, not what is really there".

Puzzled look.

Let's have a look at some old vertebrae that we have here:

What should we pay attention to while observing these Forms?

On both sides (upper and lower) of the vertebral body the original border of the vertebrae is clearly visible by the hard 'ring like' bone which was the junction with the intervertebral discs 'lamina fibrosus'. The normal Form of the vertebral body is actually pretty square like if you take a frontal view. (return after each sentence back to the images and see)

If for whatever reason there is a chronic dysbalance in the structural load on these bodies, the connective or inner tissue reacts with Form changes:

Exostosis formation, adding more bone and as such enlarging the support surface thus decreasing the local load distribution. (This is partly by transforming ligaments and other strong connective structures into bone)

This phenomenon is clearly visible as the exostosis grows away from the 'discus ring'. If this is not enough to compensate the situation, the whole vertebral body will in time get a "Diabolo" form instead of of a square, as visible on the last picture.

The very last place, where this exostosis phenomenon happens, is there where the vertebral body and discs have a close relation with the aorta.

Why?

Let's not forget that the aorta (except the arcus aortae), is a relatively rigid structure, with extremely little length elasticity or pull compliance. A relatively stiff tube, with a high pressure fluid inside it.

So actually the aorta could be considered as the pressure spine or (front) backbone of the spine (columna vertebralis), giving it support - reinforcement to the carrying of the loads. The forces at play, by the load, are shared between both, where the strong contact exists between aorta and spine.

Thus we can observe, that actually the place where the vertebra deforms the least is exactly that aortic-vertebral body junction surface.

So what looks and feels almost as if the aorta erodes, or as some authors even described, 'bites' it's way into the spinal bodies, it is actually exactly the contrary that happens!

The exostosis and resurfacing or remodeling of the whole vertebral bodies is happening everywhere first, where there is not such a load sharing with the aortic pillar.

The junction between vertebral body and aorta will eventually deform in time, if the load overcomes the strength of both joined forces, but in most cases the resistance of combined forces is enough to maintain the form.

As is visible on the last picture, it is possible that deformation happens even there, but clearly less than where there was no aortic support. ( My thumb in that picture is in the line of the aortic support pillar.)

Remember: "What seems to be a global order in our eyes, is actually only the result of very local interactions." or Forces as Drew says.

G. (The Fellow) was looking in bewilderment, his brain processing fast, and suddenly he bursted out in a laughter, shaking his head...

Fiat Lux, the light shone in his mind, ha ha ha.

A successful last fifteen minutes, and another generally accepted beautiful anatomical hoax, bites the dust, killed by a brutal gang of natural facts and reasoning...

Greetings from the plains of Halle...

Maybe one day I should do the same with the hoaxes of the vertebral articulations and senseless stories on the foramen intervertebrale...but not now I must run.