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https://www.readbyqxmd.com/read/29656630/etiopathogenesis-of-traumatic-spinal-epidural-hematoma
#1
Francesco Ciro Tamburrelli, Maria Concetta Meluzio, Giulia Masci, Andrea Perna, Aaron Burrofato, Luca Proietti
Spinal epidural hematoma (SEH) is a rare cause of nerve root or cord compression; its pathogenesis is not always clearly recognizable. The aim of this paper was to investigate possible etiopathological factors in a consecutive series of patients affected by traumatic SEH treated at our institution. Seven patients with neurologic impairment due to traumatic SEH were retrospectively analyzed after diagnosis and surgical treatment. Thoracic localization was found in 5 cases, and lumbar and cervical localization were found in 1 patient each...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29656623/superior-and-middle-cluneal-nerve-entrapment-as-a-cause-of-low-back-pain
#2
REVIEW
Toyohiko Isu, Kyongsong Kim, Daijiro Morimoto, Naotaka Iwamoto
Low back pain (LBP) is encountered frequently in clinical practice. The superior and the middle cluneal nerves (SCN and MCN) are cutaneous nerves that are purely sensory. They dominate sensation in the lumbar area and the buttocks, and their entrapment around the iliac crest can elicit LBP. The reported incidence of SCN entrapment (SCN-E) in patients with LBP is 1.6%-14%. SCN-E and MCN entrapment (MCN-E) produce leg symptoms in 47%-84% and 82% of LBP patients, respectively. In such patients, pain is exacerbated by lumbar movements, and the symptoms mimic radiculopathy due to lumbar disorder...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29649086/the-morphology-and-clinical-significance-of-the-extraforaminal-ligaments-at-the-t1-t12-levels
#3
Qinghao Zhao, Weicong Zhang, Zhihai Su, Min Wang, Lianjun Yang, Enyi Zhong, Zihai Ding, Qingchu Li, Hai Lu
STUDY DESIGN: A dissection-based study of 10 embalmed human cadavers. OBJECTIVE: The purpose of this study was to describe the extraforaminal ligaments in the exit regions of the T1-T12 intervertebral foramina and to discuss their possible clinical significance. SUMMARY OF BACKGROUND DATA: The ligaments at the lumbar intervertebral foramina have been well studied. However, detailed descriptions of the extraforaminal ligaments at the T1-T12 levels are lacking...
April 11, 2018: Spine
https://www.readbyqxmd.com/read/29625919/ultrasound-guided-lateral-and-subcostal-transversus-abdominis-plane-block-in-calves-a-cadaveric-study
#4
Alessandro Mirra, Alois von Rotz, Marta Schmidhalter, Lara Moser, Daniela Casoni, Claudia Spadavecchia
OBJECTIVE: To describe and assess the ultrasound-guided transversus abdominis plane (TAP) block feasibility in calf cadavers, to compare two injection volumes and to evaluate possible undesired solution spreads. STUDY DESIGN: Prospective, descriptive, anatomic study. ANIMALS: A group of 15 bovine cadavers weighing 47±11 kg (mean±standard deviation). METHODS: Lateral (n = 24) and subcostal (n = 12) TAP block approaches were assessed...
March 15, 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29625610/a-novel-interaction-between-cx-3-cr-1-and-ccr-2-signalling-in-monocytes-constitutes-an-underlying-mechanism-for-persistent-vincristine-induced-pain
#5
Karli Montague, Raffaele Simeoli, Joao Valente, Marzia Malcangio
BACKGROUND: A dose-limiting side effect of chemotherapeutic agents such as vincristine (VCR) is neuropathic pain, which is poorly managed at present. Chemokine-mediated immune cell/neuron communication in preclinical VCR-induced pain forms an intriguing basis for the development of analgesics. In a murine VCR model, CX3 CR1 receptor-mediated signalling in monocytes/macrophages in the sciatic nerve orchestrates the development of mechanical hypersensitivity (allodynia). CX3 CR1 -deficient mice however still develop allodynia, albeit delayed; thus, additional underlying mechanisms emerge as VCR accumulates...
April 6, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29620648/epiduroscopic-laser-neural-decompression-as-a-treatment-for-migrated-lumbar-disc-herniation-case-series
#6
Jinyoung Oh, Daehyun Jo
OBJECTIVE: Epiduroscopic laser neural decompression (ELND) is one of the more invasive techniques for managing patients with herniated lumbar disc. However, ELND can be used to treat, and diagnose the epidural pathology; indications for ELND remain controversial, especially, when applied in cases of large disc extrusion and migrated disc. This paper reports cases of patients that were satisfied with the ELND procedure for migrated lumbar disc herniation. METHODS: We reviewed the medical records of patients that received ELND for migrated lumbar disc in an outpatient clinic...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29619380/the-early-clinical-outcomes-of-a-percutaneous-full-endoscopic-interlaminar-approach-via-a-surrounding-nerve-root-discectomy-operative-route-for-the-treatment-of-ventral-type-lumbar-disc-herniation
#7
Chao Shi, Weijun Kong, Wenbo Liao, Yanxiao Lu, Yao Fu, Hongquan Wen, Qian Du, Fujun Wu
The objective of this study is to introduce a method using a percutaneous full-endoscopic interlaminar approach via a surrounding nerve root discectomy (SNRD) operative route that involves removing the protrusive disc via both the shoulder and the axilla of the corresponding nerve root for the treatment of ventral-type lumbar disc herniation (VLDH) and its early clinical symptoms. Twenty-two patients with VLDH satisfied the inclusion criteria and underwent the full-endoscopic interlaminar approach operation via a SNRD successfully during the period from November 2014 to June 2016...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29614704/constitutively-reduced-sensory-capacity-promotes-better-recovery-after-spinal-cord-injury-sci-in-blind-rats-of-the-dystrophic-rcs-strain
#8
Svenja Rink, Habib Bendella, Kurdin Alsolivany, Carolin Meyer, Aliona Woehler, Ramona Jansen, Zeynep Isik, Gregor Stein, Sina Wennmachers, Makoto Nakamura, Doychin N Angelov
BACKGROUND: We compared functional, electrophysiological and morphological parameters after SCI in two groups of rats Sprague Dawley (SD) rats with normal vision and blind rats from a SD-substrain "Royal College of Surgeons" (SD/RCS) who lose their photoreceptor cells after birth due to a genetic defect in the retinal pigment epithelium. For these animals skin-, intramuscular-, and tendon receptors are major available means to resolve spatial information. OBJECTIVE: The purpose of this study was to check whether increased sensitivity in SD/RCS rats would promote an improved recovery after SCI...
March 25, 2018: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/29614356/application-of-gelatin-sponge-impregnated-with-a-mixture-of-3-drugs-to-intraoperative-nerve-root-block-to-promote-early-postoperative-recovery-of-lumbar-disc-herniation
#9
Jin Peng Du, Ding Jun Hao, Yong Fan, Yun Fei Huang, Jia Nan Zhang, Lei Hong Yuan
OBJECTIVE: To observe the effect of application of gelatin sponge impregnated a mixture of 3 drugs (GSIAM) to intraoperative nerve root block to promote early postoperative recovery of lumbar disc herniation (LDH). METHOD: A total of 265 patients with single-level LDH were retrospectively analyzed from January 2013 to October 2017. Patients were divided into intervention group and control group according to whether intraoperative application of GSIAM. All patients underwent unilateral MIS-TLIF surgery...
March 31, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29611789/superficial-branch-of-the-radial-nerve-injury-a-case-for-conscious-perioperative-arterial-cannulation
#10
John Hickman, Ahmed Chekairi
We present a case of an injury to the superficial branch of the radial nerve following unconscious radial artery cannulation in a 57-year-old gentleman for revision of lumbar spinal fusion. Nerve damage is a rare complication of this commonly used technique; whilst usually self-limiting, it can lead to a significant under-reported burden of morbidity on our patients. We discuss current norms of practice, questioning the safety of unconscious arterial cannulation, and suggest that, where possible, it should be performed in the conscious patient to minimise the risk of this rare complication...
April 2018: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29606040/decision-making-algorithm-for-minimally-invasive-approaches-to-anterior-skull-base-meningiomas
#11
Malte Ottenhausen, Kavelin Rumalla, Andrew F Alalade, Prakash Nair, Emanuele La Corte, Iyan Younus, Jonathan A Forbes, Atef Ben Nsir, Matei A Banu, Apostolos John Tsiouris, Theodore H Schwartz
OBJECTIVE Anterior skull base meningiomas are benign lesions that cause neurological symptoms through mass effect on adjacent neurovascular structures. While traditional transcranial approaches have proven to be effective at removing these tumors, minimally invasive approaches that involve using an endoscope offer the possibility of reducing brain and nerve retraction, minimizing incision size, and speeding patient recovery; however, appropriate case selection and results in large series are lacking. METHODS The authors developed an algorithm for selecting a supraorbital keyhole minicraniotomy (SKM) for olfactory groove meningiomas or an expanded endoscopic endonasal approach (EEA) for tuberculum sella (TS) or planum sphenoidale (PS) meningiomas based on the presence or absence of olfaction and the anatomical extent of the tumor...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29604972/cryptococcal-meningitis-in-aids
#12
Andrej Spec, William G Powderly
Cryptococcal meningitis remains a significant cause of morbidity and mortality amongst patients living with human immunodeficiency virus (HIV). The prevalence in the developed world has decreased as HIV is being diagnosed earlier, but is still significant, and the prevalence in resource-limited settings is exceedingly high. The presenting symptoms usually include a headache, fever, and, less often, cranial nerve abnormalities. Space-occupying lesions do occur, but are rare. Once diagnosed, patients should be treated with a combination of amphotericin and flucytosine, with step-down therapy to fluconazole for a minimum of a year, or until the CD4 count is above 100 cells/μL, whichever is longer...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29597019/quantitative-evaluation-of-compressed-l4-5-and-s1-nerve-roots-of-lumbar-disc-herniation-patients-by-diffusion-tensor-imaging-fiber-tractography
#13
Ai He, Wen-Zheng Wang, Peng-Fei Qiao, Guo-Yong Qiao, Hao Cheng, Ping-Yong Feng
OBJECTIVE: We sought to delineate the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of compressed nerve roots in lumbar disc herniation patients by diffusion tensor imaging (DTI) and fiber bundle tracing and further investigated the relationship between FA or ADC values and the swiss spinal stenosis questionnaire (SSSQ) scores and the visual analog scale (VAS) scores. METHODS: Twenty patients with lumbar disc herniation and 20 age and sex-matched healthy volunteers were assessed using the SSSQ and VAS...
March 26, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29588904/endoscopic-endonasal-approach-for-complex-macroadenoma-with-suprasellar-and-retrochiasmatic-extension
#14
Edinson Najera, Carl H Snyderman, Juan C Fernandez-Miranda
In this video, we describe the technical nuances of an endoscopic endonasal approach (EEA) for a complex macroadenoma with suprasellar and retrochiasmatic extension. The patient is a 51-year-old male with several years' history of progressive visual loss. Neuro-ophthalmology assessment revealed a profound visual loss with homonymous hemianopsia and left optic nerve atrophy. His pituitary hormonal profile was normal. The options for surgical approach included transcranial, endoscopic endonasal, or a combination of both...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29582973/transforaminal-percutaneous-endoscopic-lumbar-discectomy-outcome-and-complications-in-270-cases
#15
Leonello Tacconi, Sara Baldo, Giorgio Merci, Gerardo Serra
BACKGROUND: The endoscopic approach has been introduced in the clinical practice in 1980 with the aim to remove the pro- lapsed disk and free the compressed nerve using the least disruptive surgical technique, assuring in the same time, the resolution of the symptoms and a faster return back to normal life activity. Over the years, thanks to an extraordinary technical improvement either in terms of quality of images and development of many dif- ferent tailored instrumentations there has been a huge spreading of the endoscope use across the different surgical fields...
March 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29581017/transforaminal-endoscopic-decompression-for-lumbar-spinal-stenosis-a-novel-surgical-technique-and-clinical-outcomes
#16
Sang-Ha Shin, Jun-Seok Bae, Sang-Ho Lee, Han-Joong Keum, Ho-Jin Kim, Won-Seok Jang
OBJECTIVE: Transforaminal endoscopic treatment has been reported to be an effective treatment option in patients with lumbar disc herniation. However, it is rarely performed for spinal stenosis because of the limitation of endoscopic working mobility due to the exiting nerve root and foraminous bony structure. The objective of the present study was to describe a novel transforaminal endoscopic decompression technique for spinal stenosis and report the clinical results. METHODS: From October 2015 to October 2016, 30 consecutive cases were diagnosed as lateral recess stenosis in our institution and underwent transforaminal endoscopic decompression...
March 23, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29578874/extradural-arachnoid-cyst-excision
#17
Barrett Boody, Christopher J Lucasti, Gregory D Schroeder, Joshua E Heller, Alexander R Vaccaro
Arachnoid cysts are an uncommon postoperative complication and can result in back pain, radiculopathy, and/or cauda equina syndrome. For symptomatic postoperative arachnoid cysts, surgical management is the accepted treatment. While excision of arachnoid cysts is the preferred surgical method, cysts with adhesions to nerve roots and/or dura can be treated with cyst fenestration to reduce morbidity of excision. Surgeons should be prepared for dural defects after cyst excision, which can require dural grafting and lumbar drains for cerebrospinal fluid diversion...
March 23, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29575220/lumbosacral-plexus-root-thickening-establishing-normal-root-dimensions-using-magnetic-resonance-neurography
#18
Hernán Chaves, Mariana Bendersky, Romina Goñi, César Gómez, Martín Carnevale, Claudia Cejas
INTRODUCTION: Disorders affecting the lumbosacral plexus (LSP) can alter root diameter. Our aim was to determine normal LSP nerve root dimensions using magnetic resonance neurography (MRN). MATERIALS AND METHODS: Eleven asymptomatic patients (ages: 18-53, mean: 34 years) underwent MRN of the LSP on a 3T scanner with an 8-channel torso-PA coil. IDEAL T2-weighted images were acquired and nerve root dimensions were measured from the second lumbar (L2) to the first sacral (S1) vertebrae on the coronal plane, 5 mm from the dorsal root ganglion (DRG)...
March 25, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29565958/the-morphology-and-possible-clinical-significance-of-the-intraforaminal-ligaments-in-the-entrance-zones-of-the-l1-l5-levels
#19
Enyi Zhong, Qinghao Zhao, Benchao Shi, Yushan Xie, Zihai Ding, Hai Lv, Shizhen Zhong, Wenhua Huang
BACKGROUND: The extraforaminal ligaments between the L1-L5 lumbar spinal nerves and the tissues surrounding the intervertebral foramina (IVF) have been well studied. However, little research has been performed to describe the local anatomy of the entrance zones at the L1-L5 level. Detailed anatomic studies of the intraforaminal ligaments (IFLs) in the entrance zones at the L1-L5 levels have not been performed. OBJECTIVES: The objective of this study is to identify and describe the IFLs in the entrance zones of the L1-L5 IVF and to determine their possible clinical significance...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29565953/unique-complications-of-percutaneous-endoscopic-lumbar-discectomy-and-percutaneous-endoscopic-interlaminar-discectomy
#20
Chuanli Zhou, Guoqing Zhang, Ripul R Panchal, Xianfeng Ren, Hongfei Xiang, Ma Xuexiao, Xiaoliang Chen, Gu Tongtong, Wang Hong, Alana D Dixson
BACKGROUND: Percutaneous endoscopic discectomy (PED) includes 2 main procedures: percutaneous endoscopic lumbar discectomy (PELD) and percutaneous endoscopic interlaminar discectomy (PEID), both of which are minimally invasive surgical procedures that effectively deal with lumbar degenerative disorders. Because of the challenging learning curve for the surgeon and the individual characteristics of each patient, preventing and avoiding complications is difficult. The most common complications, such as nucleus pulposus omission, nerve root injury, dural tear, visceral injury, nerve root induced hyperalgesia or burning-like nerve root pain, postoperative dysesthesia, posterior neck pain, and surgical site infection, are difficult to avoid; however, more focus on these issues perioperatively may be in order...
March 2018: Pain Physician
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