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Thoracic nerves

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https://www.readbyqxmd.com/read/28731927/injectate-spread-following-anterior-sub-costal-and-posterior-approaches-to-the-quadratus-lumborum-block-a-comparative-cadaveric-study
#1
Hesham Elsharkawy, Kariem El-Boghdadly, Sree Kolli, Wael A S Esa, Sean DeGrande, Loran M Soliman, Richard L Drake
BACKGROUND: The dermatomal level of analgesia achieved with quadratus lumborum blocks varies according to the location of injection. The most commonly used approaches are either at the postero-lateral aspect or anterior to the quadratus lumborum muscle. The aim of the study was to determine whether the site of injection of contrast dye around the quadratus lumborum muscle of cadavers affects the extent and mechanism of dye spread. METHODS: Six fresh human cadavers received either a posterior quadratus lumborum block or an anterior sub-costal quadratus lumborum block on each side...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28719560/perioperative-and-delayed-major-complications-following-surgical-treatment-of-adolescent-idiopathic-scoliosis
#2
Carrie E Bartley, Burt Yaszay, Tracey P Bastrom, Suken A Shah, Baron S Lonner, Jahangir Asghar, Firoz Miyanji, Amer Samdani, Peter O Newton
BACKGROUND: Reporting accurate surgical complication rates to patients and their families is important in the management of adolescent idiopathic scoliosis (AIS). In this study, we report the rate of major complications following the surgical treatment of AIS both in the perioperative period and among patients with a minimum of 2 years of follow-up. METHODS: We reviewed the prospectively collected data of a multicenter registry of patients who underwent surgical treatment of AIS during the period of 1995 to 2014 in order to identify all complications...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28716694/-isolated-long-thoracic-nerve-palsy-more-than-meets-the-eye
#3
Andrés A Maldonado, Scott L Zuckerman, B Matthew Howe, Michelle L Mauermann, Robert J Spinner
INTRODUCTION: Two main hypotheses have been proposed for the pathophysiology of long thoracic nerve (LTN) palsy: nerve compression and nerve inflammation. We hypothesized that critical reinterpretation of electrodiagnostic (EDX) studies and MRIs of patients with a diagnosis of non-traumatic isolated LTN palsy could provide insight into the pathophysiology and, potentially, the treatment. MATERIAL AND METHODS: A retrospective review was performed of all patients with a diagnosis of non-traumatic isolated LTN palsy and an EDX and brachial plexus or shoulder MRI studies performed at our institution...
June 27, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28710985/spinal-cord-compression-secondary-to-idiopathic-thoracic-epidural-lipomatosis-in-an-adolescent-a-case-report-and-review-of-literature
#4
Rumaiza Al-Yafeai, Yazid Maghrabi, Hussein Malibary, Saleh Baeesa
INTRODUCTION: Spinal epidural lipomatosis (SEL) is a rare condition that presents with progressive spinal cord or nerve root compression. It is commonly reported in patients receiving long-term exogenous steroid therapy or in patients with endogenous steroid overproduction. The occurrence of this condition as an idiopathic entity is rarely reported. CASE PRESENTATION: The authors present the clinical course and outcome of a 16-year-old male student, who presented with progressive spastic paraparesis of a one-year duration caused by idiopathic spinal epidural lipomatosis...
July 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28710663/a-multi-train-electrical-stimulation-protocol-facilitates-transcranial-electrical-motor-evoked-potentials-and-increases-induction-rate-and-reproducibility-even-in-patients-with-preoperative-neurological-deficits
#5
Shuta Ushio, Shigenori Kawabata, Satoshi Sumiya, Tsuyoshi Kato, Toshitaka Yoshii, Tsuyoshi Yamada, Mitsuhiro Enomoto, Atsushi Okawa
This study sought to evaluate the facilitation effect of repetitive multi-train transcranial electrical stimulation (mt-TES) at 2 repetition rates on transcranial electrical motor evoked potential (Tc-MEP) monitoring during spinal surgery, and to assess the induction rate in patients with impaired motor function from a compromised spinal cord or spinal nerve. We studied 32 consecutive patients with impaired motor function undergoing cervical or thoracic spinal surgery (470 muscles). A series of 10 TESs with 5 pulse trains were preoperatively delivered at 2 repetition rates (1 and 5 Hz)...
July 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28706767/surgical-excision-of-a-symptomatic-thoracic-nerve-root-perineural-cyst-resulting-in-complete-resolution-of-symptoms-a-case-report
#6
Zaid Aljuboori, Alae Yaseen, Jessica Simpson, Maxwell Boakye
Tarlov (perineural) cysts of the nerve root are common and usually incidental findings during magnetic resonance imaging (MRI) of the lumbosacral spine. There are a few case reports where symptomatic thoracic perineural cysts have been described in the literature. We report a case of a high thoracic nerve root perineural cyst that failed conservative therapy, requiring surgical intervention. Our patient presented with radicular symptoms involving the left hand. Imaging workup revealed a cystic lesion of the left T1 nerve root at the level of the foramen...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28698895/using-anatomical-landmark-to-avoid-phrenic-nerve-injury-during-balloon-based-procedures-in-atrial-fibrillation-patients
#7
Nicolina M Smith, Larry Segars, Travis Kauffman, Anthony B Olinger
PURPOSE: Atrial fibrillation (AF) is an arrhythmia which affects as many as 2.7 million Americans. AF should be treated, because it can lead to a four-to-fivefold increased risk of experiencing a stroke. The American College of Cardiology/American Heart Association guidelines for the treatment of drug refractory and symptomatic paroxysmal AF denote catheter ablation as the standard of care. The newest ablation treatment, cryoballoon, uses a cold balloon tip. The biggest risk factor associated with the cryoballoon ablation is phrenic nerve injury (PNI)...
July 11, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28695275/invasive-intramedullary-melanotic-schwannoma-case-report-and-review-of-the-literature
#8
Xing Cheng, Jiagang Liu, Jun Le, Siqing Huang, Haifeng Chen, Chao You
PURPOSE: Melanotic schwannoma (MS) is rare, accounting for less than 1% of primary peripheral nerve sheath tumors, and most often occurs in the paraspinal nerve roots. Intramedullary MS is exceedingly rare, and to the best of our knowledge, only nine cases have been reported in literature. METHODS AND RESULTS: We present a 47-year-old male, who underwent excision of thoracic intraspinal space-occupying lesion 6 years ago, as the 10th known case to date of intradural intramedullary MS that had a more invasive growth pattern than those reported before, and we review the diagnosis, clinicopathologic features, treatment and prognosis of intramedullary MS...
July 10, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28693584/-long-term-stability-of-stimulating-spiral-nerve-cuff-electrodes-on-human-peripheral-nerves
#9
Breanne P Christie, Max Freeberg, William D Memberg, Gilles J C Pinault, Harry A Hoyen, Dustin J Tyler, Ronald J Triolo
BACKGROUND: Electrical stimulation of the peripheral nerves has been shown to be effective in restoring sensory and motor functions in the lower and upper extremities. This neural stimulation can be applied via non-penetrating spiral nerve cuff electrodes, though minimal information has been published regarding their long-term performance for multiple years after implantation. METHODS: Since 2005, 14 human volunteers with cervical or thoracic spinal cord injuries, or upper limb amputation, were chronically implanted with a total of 50 spiral nerve cuff electrodes on 10 different nerves (mean time post-implant 6...
July 11, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28688935/indirect-transfer-of-the-sternal-head-of-the-pectoralis-major-with-autogenous-semitendinosus-augmentation-to-treat-scapular-winging-secondary-to-long-thoracic-nerve-palsy
#10
Tao Li, Ze Z Yang, Yuan Deng, Ming Xiao, Chuan Jiang, Jin W Wang
BACKGROUND: Scapular winging resulting from long thoracic nerve palsy is uncommon but debilitating, and the choice of surgical treatment is inconsistent. The autogenous semitendinosus tendon plays a key role as an interposed tendon graft, although its use in the indirect transfer of the sternal head of the pectoralis major during the treatment of scapular winging has rarely been reported. MATERIALS AND METHODS: A retrospective review was performed during a 9-year period from the clinical data of 26 cases (28 shoulders) with indirect transfer of the sternal head of the pectoralis major with the interposition of an autogenous semitendinosus tendon graft for dynamic stabilization of the scapula...
July 5, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28681978/video-assisted-thoracic-surgery-and-jejunal-reconstruction-in-a-case-of-situs-inversus-totalis-with-esophageal-cancer
#11
Kei Hosoda, Keishi Yamashita, Hiromitsu Moriya, Mitsuru Nemoto, Hiroaki Mieno, Akira Ema, Marie Washio, Masahiko Watanabe
A 78-year-old man with situs inversus totalis who had a previous history of distal gastrectomy for gastric cancer was referred to our hospital for treatment of esophageal cancer. He was diagnosed as cT2N0M0 and underwent video-assisted thoracic surgery and open completion gastrectomy with jejunal reconstruction via the ante-thoracic route. The postoperative period was uneventful except for transient palsy of the right recurrent laryngeal nerve. Based on a preoperative assessment of anatomical abnormality and an intraoperative adaptation to the mirror image of the standard procedure, video-assisted esophagectomy was considered safe and feasible...
July 6, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28677632/ultrasonographic-diagnosis-of-thoracic-outlet-syndrome-secondary-to-brachial-plexus-piercing-variation
#12
Vanessa Leonhard, Gregory Caldwell, Mei Goh, Sean Reeder, Heather F Smith
Structural variations of the thoracic outlet create a unique risk for neurogenic thoracic outlet syndrome (nTOS) that is difficult to diagnose clinically. Common anatomical variations in brachial plexus (BP) branching were recently discovered in which portions of the proximal plexus pierce the anterior scalene. This results in possible impingement of BP nerves within the muscle belly and, therefore, predisposition for nTOS. We hypothesized that some cases of disputed nTOS result from these BP branching variants...
July 4, 2017: Diagnostics
https://www.readbyqxmd.com/read/28673764/how-to-assess-sensory-recovery-after-breast-reconstruction-surgery
#13
Helena K Puonti, Taina A Broth, Seppo O Soinila, Helena K Hallikainen, Satu K Jääskeläinen
BACKGROUND: We evaluated clinical against psychophysical (tactile and thermal quantitative sensory test [QST]), neurophysiologic (somatosensory evoked potential [SEP]), and epithelial nerve fiber density (ENFD) examinations in detection and follow-up of sensory alterations after breast reconstruction done with or without nerve anastomoses. PATIENTS AND METHODS: In a prospective 2-year follow-up design, 56 breast cancer patients underwent innervated and 20 patients noninnervated free rectus abdominis muscle-sparing flap (ms-TRAM) breast reconstruction...
April 29, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28658876/combined-left-recurrent-laryngeal-nerve-and-phrenic-nerve-palsy-a-rare-presentation-of-thoracic-aortic-aneurysm
#14
Pradosh Kumar Sarangi, Pratisruti Hui, H S Sagar, Dinesh Kumar Kisku, Jayashree Mohanty
Hoarseness of voice due to Vocal Cord Palsy (VCP) resulting from aortic aneurysm is a rare entity. Hoarseness due to left Recurrent Laryngeal Nerve (RLN) paralysis caused by identifiable cardiovascular disease has been described as Ortner's syndrome or Cardiovocal syndrome. Very rarely, thoracic aortic aneurysm can cause Phrenic Nerve (PN) palsy causing hemidiaphragm paralysis. But, aortic aneurysm causing both RLN and PN palsy is an extremely rare occasion. Our literature review showed only three cases of combined RLN and PN palsy due to thoracic aortic aneurysm...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28654558/the-efficacy-of-ultrasound-guided-type-ii-pectoral-nerve-blocks-in-perioperative-pain-management-for-immediate-reconstruction-after-modified-radical-mastectomy-a-prospective-randomized-study
#15
Kaiyuan Wang, Xiaobei Zhang, Tingting Zhang, Hui Yue, Shan Sun, Hongwei Zhao, Peng Zhou
OBJECTIVES: The pectoral nerves (Pecs) II block is a technique that places local anesthetic between the thoracic muscles to block the axillary and breast regions. This study aimed to compare the quality of perioperative analgesia and side effects of the Pecs II block under general anesthesia versus general anesthesia alone in immediate unilateral breast reconstruction with an implant and latissimus dorsi (LD) flap after modified radical mastectomy. METHODS: Sixty-four patients scheduled for immediate breast reconstruction after modified radical mastectomy were randomly allocated into the Pecs II block under general anesthesia group (Group P, n=32) or the general anesthesia alone group (Group G, n=32)...
June 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28648533/recurrent-laryngeal-nerve-injury-and-swallowing-dysfunction-in-neonatal-aortic-arch-repair
#16
Kamal K Pourmoghadam, William M DeCampli, Mark Ruzmetov, James Kosko, Sami Kishawi, Michael O'Brien, Amanda Cowden, Kurt Piggott, Harun Fakioglu
BACKGROUND: We evaluated the incidence, clinical effect, and recovery rate of vocal cord dysfunction (VCD) and swallowing dysfunction in neonates undergoing aortic arch repair. METHODS: We retrospectively evaluated 101 neonates who underwent aortic arch reconstruction from 2008 to 2015. Direct flexible laryngoscopy was performed in 89 patients before initiation of postoperative oral feeding after Norwood (n = 63) and non-Norwood (n = 26) arch reconstruction. We defined VCD as immobility of vocal cords or their lack of coaptation and poor mobility...
June 22, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28646592/influence-of-inspiratory-resistive-loading-on-expiratory-muscle-fatigue-in-healthy-humans
#17
Carli M Peters, Joseph F Welch, Paolo B Dominelli, Yannick Molgat-Seon, Lee M Romer, Donald C McKenzie, A William Sheel
Expiratory resistive loading elicits inspiratory as well as expiratory muscle fatigue, suggesting parallel co-activation of the inspiratory muscles during expiration. It is unknown whether the expiratory muscles are similarly co-activated to the point of fatigue during inspiratory resistive loading (IRL). The purpose of this study was to determine whether IRL elicits expiratory as well as inspiratory muscle fatigue. Healthy male subjects (n = 9) underwent isocapnic IRL (60% maximal inspiratory pressure, 15 breaths∙min(-1) , 0...
June 24, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28643890/anatomical-evaluation-of-the-thoracolumbar-nerves-related-to-the-transversus-abdominis-plane-block-technique-in-the-dog
#18
F E Castañeda-Herrera, E F Buriticá-Gaviria, D F Echeverry-Bonilla
Transversus abdominis plane (TAP) is a fascial plane containing the thoracolumbar nerve branches that innervate the abdominal wall. Limited information is available on the anatomical organization of these nerve branches in the dog, which is of great importance for the success of the TAP block anaesthetic technique. The aim of this study was to describe the origin and conformation of thoracolumbar nerves running through the TAP in 20 hemi-abdominal walls of 10 adult mongrel dog cadavers with an average body weight of 12...
June 23, 2017: Anatomia, Histologia, Embryologia
https://www.readbyqxmd.com/read/28639723/changes-in-the-inspiratory-pattern-contribute-to-modulate-the-sympathetic-activity-in-sino-aortic-denervated-rats
#19
Mateus R Amorim, Leni G H Bonagamba, George M P R Souza, Davi J A Moraes, Benedito H Machado
The activity of pre-sympathetic neurons is under respiratory modulation and changes in the central respiratory network may impact on the baseline sympathetic activity and mean arterial pressure (MAP). It is well known that after baroreceptor afferents removal (sino-aortic denervation, SAD), rats present an unexpected normal levels of MAP. We hypothesized that changes in the respiratory pattern and in the respiratory modulation of the sympathetic activity contribute to keep the sympathetic outflow in a normal range of variation in absence of arterial baroreceptors in rats...
June 22, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28638296/ultrasound-guided-percutaneous-cervical-and-upper-thoracic-sympathetic-chain-neuromodulation-for-upper-extremity-complex-regional-pain-syndrome
#20
Samer Narouze, Dmitri Souzdalnitski
BACKGROUND: Complex regional pain syndrome (CRPS) comprises a group of conditions characterized by severe, debilitating pain that is disproportionate to any inciting event and is not distributed in a specific nerve distribution or dermatome. CASE REPORT: A 42-year-old female with a 2-year history of right upper extremity CRPS type I refractory to conventional management underwent an ultrasound-guided and fluoroscopy confirmed percutaneous peripheral nerve stimulation trial with a lead extending from the C6 to the T3 level to cover the cervical and upper thoracic sympathetic chain...
2017: Ochsner Journal
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