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Lumbar nerves

Anand Kaul, Sunil Manjila, Jonathan P Miller
: Isadore Max Tarlov (1905-1977) is primarily remembered for his 1938 description of the eponymous perineural "Tarlov cyst." However, during his long career as a neurosurgeon and researcher, he was responsible for many other observations and inventions that influenced the development of neurosurgery in the 20th century. While studying at Johns Hopkins Medical School he was acquainted with Walter Dandy, and he became the first resident to study under Wilder Penfield at the newly formed Montreal Neurological Institute...
November 2016: Neurosurgery
Shaishav Bhagat, Alexander Z E Durst, Am S Rai
With an increasingly aging population, adult spinal deformity is becoming more common. This can be associated with increased morbidity. Results from multicentre studies of deformity surgery correction confirm complication rates as high as 40 percent. Most often a bad result is associated with inadequate restoration of the sagittal balance. Posterior vertebral body resection has been described as a method to correct significant deformity, but this is a complicated procedure. It is possible to do this in the thoracic spine where nerve roots can be sacrificed, but it is difficult in the lumbar spine due to the significant role of the lumbar nerve roots...
September 2016: J Spine Surg
Yasuaki Imajo, Tsukasa Kanchiku, Hidenori Suzuki, Masahiro Funaba, Norihiro Nishida, Kazuhiro Fujimoto, Toshihiko Taguchi
INTRODUCTION: Lumbar spinal stenosis (LSS) typically presents with neurogenic intermittent claudication (NIC). The aim is to investigate cauda equina conduction time (CECT) in patients with NIC caused by LSS and its relationship with age and body height in normal subjects. METHODS: The study included 172 normal subjects (mean age 44.1 ± 16.6 years; mean height 163.7 ± 8.9 cm). (Group C) 47 patients (mean age 71.3 ± 8.7 years; mean height 158.8 ± 11.2 cm) underwent surgery due to NIC in cauda equina type for LSS...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Weifei Wu, Jie Liang, Ying Chen, Aihua Chen, Bin Wu, Zong Yang
To investigate the microstructural changes in compressed nerves using diffusion tensor imaging (DTI) of herniated disc treated with percutaneous transforaminal endoscopic discectomy.Diffusion tensor imaging has been widely used to visualize peripheral nerves, and the microstructure of compressed nerve roots can be assessed using DTI. However, the microstructural changes after surgery are not well-understood in patients with lumbar disc herniation.Thirty-four consecutive patients with foraminal disc herniation affecting unilateral sacral 1 (S1) nerve roots were enrolled in this study...
October 2016: Medicine (Baltimore)
Chang-Qing Zhao, Wei Ding, Kai Zhang, Jie Zhao
BACKGROUND: Large lumbar or lumbosacral (LS) disc herniations usually expand from the paramedian space to the neuroforamen and compress both the transversing (lower) and the exiting (upper) nerve roots, thus leading to bi-radicular symptoms. Bi-radicular involvement is a statistically significant risk factor for poor outcome in patients presenting with far lateral or foraminal disc herniation after facet preserving microdecompression. There is evidence showing that patients suffering from large lumbar disc herniations treated with interbody fusion have significant superior results in comparison with those who received a simple discectomy...
September 2016: Indian Journal of Orthopaedics
Hyun Ho Shin, Young Hoon Jeon, Seung Won Jang, Sae Young Kim
Muscular hypertrophy is caused mainly due to myopathic disorder. But, it is also rarely produced by neurogenic disorder. A 74-year-old woman complained of right calf pain with hypertrophy for several years. Recent lumbar spine magnetic resonance imaging (MRI) showed central and lateral canal narrowing at the L4-L5 intervertebral space. Lower extremity MRI revealed fatty change of right medial head of the gastrocnemius and soleus, causing right calf hypertrophy. Electrodiagnostic examinations including electromyography and nerve conduction velocity testing demonstrated 5(th) lumbar and 1(st) sacral polyradiculopathy...
October 2016: Korean Journal of Pain
Rahul Gujrathi, Kanchan Gupta, Chetan Ravi, Bhujang Pai
BACKGROUND: Sciatica has been classically described as pain in the back and hip with radiation in the leg along the distribution of the sciatic nerve, secondary to compression or irritation of the sciatic nerve. Spinal abnormality being the most common etiology, is one of the most common indications for MRI of the lumbosacral spine. Here we describe imaging findings secondary to a supralevator perianal abscess causing irritation of the sciatic nerve, which was diagnosed on MRI of the lumbosacral spine...
2016: Polish Journal of Radiology
Masaaki Nishihara, Ko Takesue, Yoshitaka Hirooka
OBJECTIVE: Sympathoexcitation plays an important role in the pathogenesis of hypertension in patients with chronic kidney disease (CKD). The paraventricular nucleus of the hypothalamus (PVN) in the brain controls sympathetic outflow through γ-amino butyric acid (GABA)-ergic mechanisms. Renal denervation (RDN) exerts a long-term antihypertensive effect in hypertension with CKD; however, the effects of RDN on sympathetic nerve activity and GABA-ergic modulation in the PVN are not clear...
October 4, 2016: Autonomic Neuroscience: Basic & Clinical
Atsushi Mizuma, Chikage Kijima, Eiichiro Nagata, Shunya Takizawa
Metastasis of breast cancer is often detected through a long-term course and difficult to diagnose. We report a case of brachial plexopathy suspected to be the initial lesion of breast cancer metastasis, which was only detected by magnetic resonance (MR) neurography. A 61-year-old woman was admitted to our hospital within 2 years after operation for breast cancer because of progressive dysesthesia and motor weakness initially in the upper limb on the affected side and subsequently on the contralateral side...
May 2016: Case Reports in Oncology
Ahmad Jabir Rahyussalim, Ifran Saleh, M Fajrin Armin, Tri Kurniawati, Ahmad Yanuar Safri
INTRODUCTION: Intraoperative neurophysiologic monitoring (IONM) had important role related to the complications in spinal surgery. Somatosensory Evoked Potential (SSEP), Transcranial electric Muscle Evoked Potentials (tceMEPs), and free run EMG are parameters used to asses functional integrity of the nervous system during surgical procedures. Once warning signal was recognized, surgeon have to make a precise decision to overcome that problem. PRESENTATION OF CASE: We present a 47-year old male with back pain due to compression fracture of thoracic vertebra T12 and lumbar vertebrae L1...
September 23, 2016: International Journal of Surgery Case Reports
Edvin Zekaj, Claudia Menghetti, Christian Saleh, Alessandra Isidori, Alberto R Bona, Enrico Aimar, Domenico Servello
BACKGROUND: Intraforaminal disc herniations at the L5-S1 level are extremely surgically challenging lesions. Intracanal approaches frequently require partial or total facetectomy, which may lead to instability. Solely extraforaminal approaches may offer limited visualization of the more medial superiorly exiting and inferiorly exiting nerve roots; this approach is also more complicated at L5-S1 due to the often large L5 transverse process and the iliac wing. METHODS: Nine patients with intraforaminal L5-S1 disc herniations, foraminal stenosis, or synovial cysts underwent contralateral interlaminar approaches for lesion resection...
2016: Surgical Neurology International
Sol Bee Han, Young Cheol Yoon, Jong Won Kwon
BACKGROUND AND PURPOSE: Slice-Encoding Metal Artifact Correction (SEMAC) sequence is one of the metal artifact reduction techniques of anatomical structure, but there has been no report about evaluation of post-operative complications. The purpose of this article is to compare the anatomical visibility between fast spin echo (FSE) and FSE-SEMAC and to evaluate the additional value of FSE-SEMAC in diagnostic confidence of the complications. MATERIALS AND METHODS: We conducted a retrospective study with 54 patients who received lumbar spinal surgery and MR images including FSE-SEMAC...
2016: PloS One
Olaf Suess, Markus Schomacher
Aim. Transpedicular screw fixation is widely used in spinal surgery. But the insertion of pedicle screws can sometimes be challenging because of the variability in pedicle size and the proximity of nerve roots. Methods. We detected intraoperatively the sensitivity for iatrogenic pedicel perforation with a hand-held electronic conductivity measurement device (ECD) that measures electrical conductivity of tissue-medium surrounding the instrument tip. ECD was used to guide the placement of 84 pedicle screws in 15 patients undergoing surgery for tumor or degenerative spinal disease at various spinal levels from T8 to L5...
2016: Advances in Medicine
He-Ping Yin, Yu-Peng Wang, Zhi-Ye Qiu, Zhi-Cai Du, Yi-Min Wu, Shu-Wen Li
This study compares the safety and efficiency of two techniques in microendoscopic discectomy (MED) for lumbar disc herniation. The two techniques are MED with automatic nerve retractor and MED with nerve hook which had been widely used for many years. The former involves a newly developed MED device which contains three parts to protect nerve roots during operation. Four hundred and twenty-eight patients underwent MED treatments between October 2010 and September 2015 were recruited and randomized to either intraoperative utilization of automatic nerve retractor (n = 315, group A) or application of nerve hook during surgery (n = 113, group B)...
October 2016: Regenerative Biomaterials
Duygu Tecer, Emre Adiguzel, Arif Kenan Tan, Mehmet Ali Taskaynatan
OBJECTIVE:  To explore the outcome differences of lumbar transforaminal epidural steroid injection (TFESI) according to magnetic resonance imaging (MRI) findings in patients with lumbar radicular pain. DESIGN:  Retrospective study. SETTING:  Single university-based interventional pain management unit. PATIENTS:  Fifty-nine patients who had lumbar radicular pain with a recent lumbar MRI and three-month follow-up were included...
October 2, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
So Hee Park, Ikchan Jeon, Sang Woo Kim
OBJECTIVE: The aim of this study is to evaluate the values of ProSet magnetic resonance coronal source imaging (ProSet MR imaging) as a diagnostic tool for detecting symptomatic lesion in patients with multiple lumbar foraminal stenosis. PATIENTS AND METHODS: From January 2011 to June 2015, 46 patients with unilateral and single-level radiculopathy developed from foraminal stenosis were enrolled in the study. These diagnoses were confirmed with transforaminal selective nerve root block (SNRB) and electrophysiological testing, including electromyography and nerve conduction velocity (EMG/NCV) tests...
November 2016: Clinical Neurology and Neurosurgery
Leigh A Rettenmaier, Brian J Park, Marshall T Holland, Youssef J Hamade, Shuchita Garg, Rahul Rastogi, Chandan G Reddy
Spontaneous intracranial hypotension (SIH) is a more common than previously noted condition (1-2.5 per 50,000) typically caused by cerebrospinal fluid (CSF) leakage. Initial treatment involves conservative therapies, but the mainstay of treatment for patients who fail conservative management is the epidural blood patch (EBP). Subdural hematoma (SDH) is a common complication occurring with SIH, but its management remains controversial. In this report, we discuss a 62-year-old female who presented with a 5-week history of orthostatic headaches associated with nausea, emesis, and neck pain...
September 27, 2016: World Neurosurgery
Patrick M House, Stefan R G Stodieck
OBJECTIVE: Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without a space-occupying cerebral lesion, venous sinus thrombosis or hydrocephalus and with normally composited cerebrospinal fluid (CSF). Main symptoms are headache, sight disturbances and potential visual impairment. Weight loss, carbonic anhydrase inhibitors, lumbar punctures with CSF drain, CSF shunting, optic nerve sheath fenestration, and venous sinus stenting are common IIH therapies...
November 2016: Clinical Neurology and Neurosurgery
F C Heider, H M Mayer
OBJECTIVE: Herniated disc tissue removal to decompress the spinal nerve/cauda equina. Minimization of iatrogenic trauma and associated injuries. INDICATIONS: Conservative treatment did not sufficiently improve clinical symptoms. This is true for progressive or persisting neurological deficits, as well as for persisting pain which alters the quality of the patient`s life. Results of surgery are strongly dependent on the preoperative duration of symptoms. Paramount is the "timing" of surgery: poorer surgical results associated with increasing preoperative duration of symptoms...
September 29, 2016: Operative Orthopädie und Traumatologie
Kevin Phan, Alexander E Dunn, Prashanth J Rao, Ralph J Mobbs
Lumbar disc herniation arises when the annulus fibrosus of the vertebral disc fails, thus allowing displacement of the nucleus pulposus and other tissue. The term far lateral is used variably in the literature and usually refers to an extraforaminal displacement in the peridiscal zone peripheral to the sagittal plane of the most lateral part of the pedicle at the same level. Non-surgical treatments of far lateral disc herniation include physical therapy, anti-inflammatory medication, and corticosteroid injections...
March 2016: J Spine Surg
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