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https://www.readbyqxmd.com/read/28430671/elevated-production-of-nociceptive-cc-chemokines-and-se-selectin-in-patients-with-low-back-pain-and-the-effects-of-spinal-manipulation-a-non-randomized-clinical-trial
#1
Julita A Teodorczyk-Injeyan, Marion McGregor, John J Triano, H Stephen Injeyan
BACKGROUND: The involvement of inflammatory components in the pathophysiology of low back pain is poorly understood. It has been suggested that spinal manipulative therapy (SMT) may exert anti-inflammatory effects. PURPOSE: To determine the involvement of inflammation-associated chemokines (CC series) in the pathogenesis of non-specific low back pain and to evaluate the effect of SMT on that process. METHODS: Patients presenting with non-radicular, non-specific low back pain (minimum pain score 3 on 10 point visual analogue scale, VAS) were recruited according to stringent inclusion criteria...
April 19, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28429700/acute-lower-extremity-paralysis-after-lower-extremity-endovascular-intervention
#2
Semi Öztürk, Muhsin Kalyoncuoğlu, Gündüz Durmuş, Adem Topçu, Mehmet Can
A 61-year-old man underwent successful percutaneous revascularization of both lower limbs with multiple stent implantations. Paralysis of right lower limb was noticed after completion of procedure when transferring the patient from angiography table. Since hematoma compressing lumbosacral neural plexus could be a fatal complication, computed tomography (CT) image was taken. CT showed bulge of distended bladder compressing stent struts. Following placement of Foley catheter, condition improved and he was subsequently discharged uneventfully...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28428485/pathological-lesions-in-the-central-nervous-system-and-peripheral-tissues-of-ddy-mice-with-street-rabies-virus-1088-strain
#3
Kazunori Kimitsuki, Kentaro Yamada, Nozomi Shiwa, Satoshi Inoue, Akira Nishizono, Chun-Ho Park
Most studies on rabies virus pathogenesis in animal models have employed fixed rabies viruses, and the results of those employing street rabies viruses have been inconsistent. Therefore, to clarify the pathogenesis of street rabies virus (1088 strain) in mice, 10(6) focus forming units were inoculated into the right hindlimb of ddY mice (6 weeks, female). At 3 days postinoculation (DPI), mild inflammation was observed in the hindlimb muscle. At 5 DPI, ganglion cells in the right lumbosacral spinal dorsal root ganglia showed chromatolysis...
April 20, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28425594/trilobed-pedicled-superior-gluteal-artery-perforator-flap-for-lumbosacral-defect-coverage
#4
Ji Min Kim, Jun Ho Lee, Deuk Young Oh, Suk-Ho Moon
BACKGROUND: There are many available options for the coverage of lumbosacral area defects. Surgeons usually use the superior gluteal artery perforator flap (SGAP) by rotational fashion, which risks complications, such as wound dehiscence or skin necrosis at the Y-point on the donor site due to the tension. In this report, the authors present the experience of using trilobed pedicled SGAP flaps in coverage of the lumbosacral area defects. METHODS: From 2011 to 2015, 16 trilobed pedicled SGAP flaps were performed for the coverage of sacral defects in our facility...
April 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28424050/in-the-quest-for-degenerative-lumbar-spinal-stenosis-etiology-the-schmorl-s-nodes-model
#5
Janan Abbas, Viviane Slon, Dan Stein, Natan Peled, Israel Hershkovitz, Kamal Hamoud
BACKGROUND: Degenerative lumbar spinal stenosis (DLSS) is a common health problem in the elderly and usually associated with three-joint complex degeneration. Schmorl's nodes (SNs) are described as vertical herniation of the disc into the vertebral body through a weakened part of the end plate that can lead to disc degeneration. Since SNs can harm the spine unit stability, the association between DLSS and SNs is expected. The aim of this study is to shed light on the relationship between degenerative lumbar spinal stenosis and SNs...
April 20, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28419438/dinosaur-tail-sign-a-useful-spinal-mri-finding-indicative-of-cerebrospinal-fluid-leakage
#6
Keita Sakurai, Masafumi Kanoto, Motoo Nakagawa, Masashi Shimohira, Aya M Tokumaru, Masashi Kameyama, Keigo Shimoji, Satoru Morimoto, Noriyuki Matsukawa, Minoru Nishio, Yuta Shibamoto
OBJECTIVE: To evaluate the imaging characteristics and diagnostic utility of the "Dinosaur tail sign" in the diagnosis of cerebrospinal fluid (CSF) leakage. BACKGROUND: The authors propose the "Dinosaur tail sign," defined as a combination of the dorsal epidural hyperintensities, fat tissue, spinal cord, and cauda equine on lumbosacral sagittal fat-suppressed T2-weighted image (FST2WI), as a sensitive indicator for diagnosing CSF leakage. METHODS: Imaging characteristics of the "Dinosaur tail sign" was evaluated in seven spontaneous intracranial hypotension (SIH) and 23 iatrogenic CSF leakage (ICSFL) patients...
April 16, 2017: Headache
https://www.readbyqxmd.com/read/28418950/sacral-fatigue-fracture-in-a-military-recruit
#7
Matthew D Burgess, Mickaila J Johnston, Eugene D Silverman
A 19-year-old male military recruit presented with 3 weeks of persistent left hip and groin pain after abnormally twisting his hip during a hike. Initial radiographs were interpreted as negative. He subsequently underwent a bone scan which revealed linear left sacral uptake along or paralleling the sacroiliac joint. Differential diagnostic considerations included unilateral sacroiliitis and sacral fracture. SPECT/CT was performed which confirmed left sacral fatigue stress fracture. Transitional lumbosacral anatomy was evident on radiographs with pseudoarticulation of the transitional left S1 transverse process with the sacrum...
April 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28417039/a-true-human-tail-in-a-neonate-case-report-and-literature-review
#8
Mahesh K Pillai, Smitha T Nair
A true human tail is a benign vestigial caudal cutaneous structure composed of adipose, connective tissue, muscle, vessels, nerves and mechanoreceptors. A true human tail can be distinguished from a pseudotail as the latter is commonly associated with underlying spinal dysraphism, which requires specialised management. True human tails are very rare, with fewer than 40 cases reported to date. We report a healthy one-day-old male newborn who was referred to the Bharath Hospital, Kottayam, Kerala, India, in 2014 with a cutaneous appendage arising from the lumbosacral region...
February 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28413533/persistent-l5-lumbosacral-radiculopathy-caused-by-lumbosacral-trunk-schwannoma
#9
Guive Sharifi, Amin Jahanbakhshi
Schwannomais, usually, benign tumor of nerve sheath that occurs evenly along the spinal cord. Intra-pelvic schwannoma is very rare entity that may arise from lumbosacral nerve roots or from sciatic nerve. Radicular pain of the lower limb as a presenting symptom of pelvic schwannoma is extremely rare. In the current report, the patient is presented with a right sided L5 radicular pain typical of lumbar discopathy. Interestingly, a herniated lumbar disc was noted on lumbosacral magnetic resonance imaging (MRI)...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28408248/extraforaminal-compression-of-the-l5-nerve-an-anatomical-study-with-application-to-failed-posterior-decompressive-procedures
#10
R Shane Tubbs, Joe Iwanaga, Islam Aly, Marc D Moisi, David R Hanscom, Jens R Chapman, Marios Loukas, Rod J Oskouian
This anatomical study was performed to elucidate the pertinent foraminal and lateral L5 nerve anatomy to enhance our understanding of possible neurologic causes of failed decompression surgery. Persistent extraforaminal L5 nerve compression is a possible cause of persistent symptoms following lumbosacral surgery. The amount of extraforaminal space for the L5 ventral ramus was examined in fifty adult human skeletons (100 sides). Based on morphology, the specimens were then categorized (types I-IV) on the basis of the bony space available for the nerve at this location...
April 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28406801/ultrasound-guided-s1-transforaminal-epidural-injection-using-the-in-plane-approach-and-color-doppler-imaging
#11
Donghwi Park
Recently, several studies have investigated the effectiveness of the ultrasound-guided lumbosacral transforaminal epidural injection. However, the ultrasound-guided S1 transforaminal epidural injection using an out-of-plane approach, which was previously reported, may cause an intestinal injury or intravascular injection because the needle tip tends to be invisible in the out-of-plane approach. In this study, therefore, we report a new method of ultrasound-guided S1 transforaminal epidural injection using the in-plane approach and color Doppler...
April 13, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28396863/real-time-ultrasound-mri-fusion-for-suprasacral-parallel-shift-approach-to-lumbosacral-plexus-blockade-and-analysis-of-injectate-spread-an-exploratory-randomized-controlled-trial
#12
Jennie Maria Christin Strid, Erik Morre Pedersen, Sinan Naseer Hussain Al-Karradi, Mathias Alrø Fichtner Bendtsen, Siska Bjørn, Mette Dam, Morten Daugaard, Martin Sejr Hansen, Katrine Danker Linnet, Jens Børglum, Kjeld Søballe, Thomas Fichtner Bendtsen
Fused real-time ultrasound and magnetic resonance imaging (MRI) may be used to improve the accuracy of advanced image guided procedures. However, its use in regional anesthesia is practically nonexistent. In this randomized controlled crossover trial, we aim to explore effectiveness, procedure-related outcomes, injectate spread analyzed by MRI, and safety of ultrasound/MRI fusion versus ultrasound guided Suprasacral Parallel Shift (SSPS) technique for lumbosacral plexus blockade. Twenty-six healthy subjects aged 21-36 years received two SSPS blocks (20 mL 2% lidocaine-epinephrine [1 : 200,000] added 1 mL diluted contrast) guided by ultrasound/MRI fusion versus ultrasound...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28387433/neurosurgical-management-and-pathology-of-lumbosacral-lipomas-with-tethered-cord
#13
REVIEW
Takato Morioka, Nobuya Murakami, Takafumi Shimogawa, Nobutaka Mukae, Kimiakai Hashiguchi, Satoshi O Suzuki, Koji Iihara
Lumbosacral lipomas are the most common form of occult spinal dysraphism. The development of lumbosacral lipomas is from the premature disjunction of the neural tube from the surrounding ectoderm, leaving the neural plate open posteriorly and allowing for the infiltration of mesodermal tissue, including fatty tissue. Since lumbosacral lipomas are a common cause of spinal cord tethering that can lead to progressive neurological deficits, prophylactic neurosurgery for lumbosacral lipomas, including untethering of the spinal cord, is recommended...
April 7, 2017: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/28385196/enabling-task-specific-volitional-motor-functions-via-spinal-cord-neuromodulation-in-a-human-with-paraplegia
#14
Peter J Grahn, Igor A Lavrov, Dimitry G Sayenko, Meegan G Van Straaten, Megan L Gill, Jeffrey A Strommen, Jonathan S Calvert, Dina I Drubach, Lisa A Beck, Margaux B Linde, Andrew R Thoreson, Cesar Lopez, Aldo A Mendez, Parag N Gad, Yury P Gerasimenko, V Reggie Edgerton, Kristin D Zhao, Kendall H Lee
We report a case of chronic traumatic paraplegia in which epidural electrical stimulation (EES) of the lumbosacral spinal cord enabled (1) volitional control of task-specific muscle activity, (2) volitional control of rhythmic muscle activity to produce steplike movements while side-lying, (3) independent standing, and (4) while in a vertical position with body weight partially supported, voluntary control of steplike movements and rhythmic muscle activity. This is the first time that the application of EES enabled all of these tasks in the same patient within the first 2 weeks (8 stimulation sessions total) of EES therapy...
April 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28384946/a-randomized-controlled-clinical-trial-to-determine-the-effectiveness-of-caudal-epidural-steroid-injection-in-lumbosacral-sciatica
#15
Jaydeep Nandi, Abhishek Chowdhery
INTRODUCTION: Caudal epidural steroid injection have been a part of nonsurgical management of lumbosacral sciatica since last half a century but various randomized controlled trials fail to provide convincing evidence in favour of its effectiveness. AIM: To assess the efficacy of caudal epidural steroid injection in patients of lumbosacral sciatica in comparison to placebo. MATERIALS AND METHODS: The study consisted of patients of sciatica caused by lumbosacral disc prolapse (observed on Magnetic Resonance Imaging (MRI) scan)...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383293/peripheral-nerve-block-as-a-supplement-to-light-or-deep-general-anesthesia-in-elderly-patients-receiving-total-hip-arthroplasty-a-prospective-randomized-study
#16
Bin Mei, Hanning Zha, Xiaolong Lu, Xinqi Cheng, Shishou Cheng, Xuesheng Liu, Yuanhai Li, Erwei Gu
BACKGROUND: Peripheral nerve block combined with general anesthesia is a preferable anesthesia method for elderly patients receiving hip arthroplasty. The depth of sedation may influence patient recovery. Therefore, we aimed to investigate the influence of peripheral nerve blockade and different intraoperative sedation levels on the short-term recovery of elderly patients receiving total hip arthroplasty. METHODS: Patients aged 65 years and older undergoing total hip arthroplasty were randomized into three groups: a general anesthesia without lumbosacral plexus block group, and two general anesthesia plus lumbosacral plexus block groups, each with a different level of sedation (light or deep)...
April 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28383090/lumbosacral-epidural-primitive-neuroectodermal-tumor-pnet-case-report-and-literature-review
#17
Keyvan Eghbal, Amir Reza Dehghanian, Fariborz Ghaffarpasand
BACKGROUND: The primitive neuroectodermal tumors (PNET) of the spine are rare and usually are intramedullary and being reported in children. We herein report an epidural PNET of lumbosacral area presenting with cauda equine syndrome in an adult. CASE REPORT: A 38-year-old woman presented to our emergency room with acute onset lower extremity weakness and urinary incontinency. Emergency MRI revealed an isoitense on T1-weighted and heterogeneously hyperintense in T2-weighted images in epidural lumbosacral area...
March 9, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28379464/filum-terminale-needle-placement-during-caudal-epidural-steroid-injection
#18
Ryan R Ramsook, David Spinner, Rajiv R Doshi
Objective. : Caudal epidural steroid injections (ESIs) are commonly used to treat lumbar radicular pain. Touhy needles are placed under live fluoroscopic guidance to ensure epidural administration of medication. This is a case report of direct needle and catheter placements into and through the filum terminale during a caudal approach to the epidural space. Design. : Single case report. Setting. : Beth Israel Deaconess Medical Center...
March 30, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28375661/pain-management-of-malignant-psoas-syndrome-under-epidural-analgesia-during-palliative-radiotherapy
#19
Takayo Ota, Masaru Makihara, Hiroshi Tsukuda, Ryuji Kajikawa, Masayuki Inamori, Nozomi Miyatake, Noriko Tanaka, Masahiro Tokunaga, Yoshikazu Hasegawa, Takuhito Tada, Masahiro Fukuoka
Malignant psoas syndrome is a rare malignant condition presenting as lumbosacral plexopathy and painful fixed flexion of the hip. Metastasis to the psoas muscle is observed, which damages the nerve bundles in the lumbosacral plexuses. The syndrome presents as refractory lower back pain with several other neurological symptoms. The pain is difficult to control because it is a mixture of nociceptive and neuropathic pain, which indicates that treatment requires a versatile approach. The authors report a case of severe back pain caused by metastasis to the psoas muscle of advanced gastric cancer in a patient who underwent palliative radiotherapy under epidural analgesia...
April 4, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28370379/prognostic-factors-associated-with-recovery-of-ambulation-and-urinary-continence-in-dogs-with-acute-lumbosacral-spinal-cord-injury
#20
T A Shaw, L De Risio, E J Laws, J H Rose, T R Harcourt-Brown, N Granger
BACKGROUND: Limited information is available about prognostic factors for recovery after spinal cord injury (SCI) to the L4-S3 segments. Previous research suggests that L4-S3 SCI does not have a worse prognosis than T3-L3 SCI. HYPOTHESIS/OBJECTIVES: To elucidate prognostic factors for regaining urinary continence and ambulation in dogs with L4-S3 SCI and compare prognosis to T3-L3 SCI. ANIMALS/METHODS: A retrospective study on 61 nonambulatory dogs with L4-S3 SCI, matched to dogs with T3-L3 SCI, compared 3 weeks after onset...
April 3, 2017: Journal of Veterinary Internal Medicine
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