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https://www.readbyqxmd.com/read/27911244/neurosurgical-management-in-lateral-meningocele-syndrome-case-report
#1
Erik C Brown, Kunal Gupta, Christina Sayama
Lateral meningocele syndrome (LMS) is a rare genetic connective tissue disorder. It is associated with morphological changes similar to those of other connective tissue disorders, with the unique distinction of multiple, often bilateral and large, lateral meningoceles herniating through the spinal foramina. In some cases, these lateral meningoceles can cause pain and discomfort due to their presence within retroperitoneal tissues or cause direct compression of the spinal nerve root exiting the foramen; in some cases compression may also involve motor weakness...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911127/immediate-and-lasting-effects-of-a-thoracic-spine-manipulation-in-a-patient-with-signs-of-cervical-radiculopathy-and-upper-extremity-hyperalgesia-a-case-report
#2
Beth K Deschenes, Jason Zafereo
Patients with cervical radiculopathy (CR) may present with accompanying symptoms of hyperalgesia, allodynia, heaviness in the arm, and non-segmental pain that do not appear to be related to a peripheral spinal nerve. These findings may suggest the presence of central or autonomic nervous system involvement, requiring a modified management approach. The purpose of this case report is to describe the treatment of a patient with signs of CR and upper extremity (UE) hyperalgesia who had a significant decrease in her UE pain and hypersensitivity after a single thoracic spine manipulation (TSM)...
December 2, 2016: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/27910227/preoperative-computed-tomography-diagnosis-of-non-recurrent-laryngeal-nerve-in-patients-with-esophageal-carcinoma
#3
Zhong-Xi Niu, Hang Zhang, Long-Qi Chen, Hui Shi, Jun Peng, Li-Wei Su, Wei Li, Bo Xiao, Shu He, Hong-Xu Yue
BACKGROUND: The non-recurrent laryngeal nerve (NRLN) is a rare but potentially serious anomaly that is commonly associated with the aberrant right subclavian artery (ARSA). It is easy to damage during surgical resection of esophageal cancer, leading to severe complications. METHODS: Preoperative enhanced thoracic computed tomography (CT) scans of 2697 patients with esophageal carcinoma treated in our hospital between January 2010 and December 2013 were examined...
December 2, 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#4
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27899127/treatment-for-thoracic-ossification-of-posterior-longitudinal-ligament-with-posterior-circumferential-decompression-complications-and-managements
#5
Baohui Yang, Yi Wang, Xijing He, Haopeng Li
BACKGROUND: The complications and corresponding managements for patients with thoracic ossification of posterior longitudinal ligament (TOPLL) who were treated with posterior circumferential decompression have not been systematically summarized yet. METHODS: Twenty-one patients with TOPLL who received posterior circumferential decompression between February 2010 and December 2014 were retrospectively reviewed. The patients' basic characteristics, surgical duration, intraoperative blood loss, Japanese Orthopaedic Association (JOA) scores, and intraoperative and postoperative complications, and the adopted managements were summarized...
November 29, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27896830/vagal-nerve-endings-in-visceral-pleura-and-triangular-ligaments-of-the-rat-lung
#6
Feng-Bin Wang, Yi-Han Liao, Yao-Chen Wang
The inner thoracic cavity is lined by the parietal pleura, and the lung lobes are covered by the visceral pleura. The parietal and visceral plurae form the pleural cavity that has negative pressure within to enable normal respiration. The lung tissues are bilaterally innervated by vagal and spinal nerves, including sensory and motor components. This complicated innervation pattern has made it difficult to discern the vagal vs. spinal processes in the pulmonary visceral pleura. With and without vagotomy, we identified vagal nerve fibres and endings distributed extensively in the visceral pleura ('P'-type nerve endings) and triangular ligaments ('L'-type nerve endings) by injecting wheat germ agglutinin-horseradish peroxidase as a tracer into the nucleus of solitary tract or nodose ganglion of male Sprague-Dawley rats...
November 29, 2016: Journal of Anatomy
https://www.readbyqxmd.com/read/27891032/clinical-anatomy-and-significance-of-the-thoracic-intervertebral-foramen-a-cadaveric-study-and-review-of-the-literature
#7
Grigorios Gkasdaris, Grigorios Tripsianis, Konstantinos Kotopoulos, Stylianos Kapetanakis
INTRODUCTION: The literature is lacking information on the anatomy and the osseous dimensions of the thoracic intervertebral foramen (IVF). We describe the anatomy of the broader area, and we proceed with morphometric data of the vertebrae and the foramina. Depiction of these features is provided with imaging and illustrations. The purpose of this paper is to survey and present the anatomy of the foramen as a whole and provide baseline statistical data. MATERIALS AND METHODS: We review relevant literature, and we present data obtained from skeletal samples of known population and sex...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27891027/purely-extradural-spinal-nerve-root-hemangioblastomas
#8
REVIEW
Murat Hamit Aytar, Ulaş Yener, Murat Şakir Ekşi, Behram Kaya, Serdar Özgen, Aydin Sav, Ahmet Alanay
Spinal nerve root hemangioblastomas present mostly as intradural-extradurally. Purely extradural spinal nerve root hemangioblastoma is a very rare entity. In this study, we aimed to analyze epidemiological perspectives of purely extradural spinal nerve root hemangioblastomas presented in English medical literature in addition to our own exemplary case. PubMed/MEDLINE was searched using the terms "hemangioblastoma," "extradural," "spinal," and "nerve root." Demographical variables of age, gender, concomitant presence of von Hippel-Lindau (VHL) disease; spinal imaging and/or intraoperative findings for tumor location were surveyed from retrieved articles...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27889103/cardiac-autonomic-changes-after-thoracic-sympathectomy-a-prospective-randomized%C3%A2-study
#9
Alfonso Fiorelli, Giovanni Messina, Paolo Chiodini, Saveria Costanzo, Andrea Viggiano, Marcellino Monda, Giovanni Vicidomini, Mario Santini
BACKGROUND: We evaluated whether cardiac autonomic changes could be associated with different extent of sympathetic nerve resection in the management of essential palmar hyperhidrosis. METHODS: Sixty patients with essential palmar hyperhidrosis were randomly allocated to undergo excision of T3 ganglia (sympathicectomy group; n = 30) or to interruption of sympathetic chain at the T2 to T3 level with ganglion sparing (sympathicotomy group; n = 30). Time and frequency domains were measured with a 24-Holter monitor during daytime, nighttime, and 24-hour periods at different interval points (7 days before operation; 24 hours; and 1, 3, and 6 months later), and the differences were statistically compared...
November 23, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27888814/diaphragmatic-dysfunction-after-thoracic-operations
#10
Henning Gaissert, Susan R Wilcox
The perioperative management of diaphragmatic weakness and phrenic nerve dysfunction is complex, due to varied etiologies and clinical presentations. The factors leading to diaphragmatic weakness may culminate after the operation with transient or persistent respiratory failure. This review discusses diaphragmatic disorders and postoperative respiratory failure caused by unilateral or bilateral diaphragmatic impairment. The origins of neuromuscular weakness involving the diaphragm are diverse, and often lie within the domains of different medical specialties, with only a portion of the condition related to surgical intervention...
November 26, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27870742/thoracic-paravertebral-nerve-blocks-in-pediatric-patients-safety-and-clinical-experience
#11
Tricia Vecchione, David Zurakowski, Karen Boretsky
Thoracic paravertebral nerve blocks (PVNBs) provide excellent analgesia for many surgeries. The primary aim was to estimate the complication rate, and secondary aims were to provide information on the potential clinical application of PVNBs. Data on 2390 PVNBs were collected. A total of 625 catheters were performed on 468 patients, and 1765 single-injection PVNBs were performed on 403 patients. There was 1 case of local anesthetic systemic toxicity for a major complication rate of 1 per 2390 PVNBs. The minor complication rate was 13...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27867556/recurrent-laryngeal-nerve-lymph-node-dissection-may-not-be-suitable-for-all-early-stage-esophageal-squamous-cell-carcinoma-patients-an-8-year-experience
#12
Shaobin Yu, Jihong Lin, Chenshu Chen, Jiangbo Lin, Ziyang Han, Wenwei Lin, Mingqiang Kang
BACKGROUND: Recurrent laryngeal nerve (RLN) injury is one of the most frequent postoperative complications of esophageal squamous cell carcinoma (ESCC) radical resection. This study aims to develop a novel scoring system to predict recurrent laryngeal nerve lymph node (RLNLN) metastases in early ESCC and explore the indications for precise RLN lymphadenectomy. METHODS: Early stage ESCC patients from 2006 to 2014 were analyzed. Patient and pathologic characteristics were compared between patients with RLNLN metastases and those without...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867546/transoral-endoscopic-mediastinal-surgery-toems-results-of-a-first-clinical-study-for-scarless-mediastinal-lymph-node-biopsies
#13
Wolfram Klemm, Steffen Frese, Gunda Leschber, André Nemat, Thomas Wilhelm
BACKGROUND: Video-assisted mediastinoscopy (VAM) represents the standard procedure for mediastinal lymph node biopsies. This operation results in a scar at prominent position at the anterior neck. Since there is a trend to less invasive procedures, natural orifice transluminal endoscopic surgery (NOTES) was introduced to different fields of surgery. Based on NOTES we developed a new approach for mediastinoscopy: transoral endoscopic mediastinal surgery (TOEMS). In previous studies using human cadavers and living pigs the feasibility of TOEMS was shown...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27856909/the-sacral-autonomic-outflow-is-sympathetic
#14
I Espinosa-Medina, O Saha, F Boismoreau, Z Chettouh, F Rossi, W D Richardson, J-F Brunet
A kinship between cranial and pelvic visceral nerves of vertebrates has been accepted for a century. Accordingly, sacral preganglionic neurons are considered parasympathetic, as are their targets in the pelvic ganglia that prominently control rectal, bladder, and genital functions. Here, we uncover 15 phenotypic and ontogenetic features that distinguish pre- and postganglionic neurons of the cranial parasympathetic outflow from those of the thoracolumbar sympathetic outflow in mice. By every single one, the sacral outflow is indistinguishable from the thoracolumbar outflow...
November 18, 2016: Science
https://www.readbyqxmd.com/read/27847703/treatment-of-post-latissimus-dorsi-flap-breast-reconstruction-pain-with-continuous-paravertebral-nerve-blocks-a-retrospective-review
#15
Jonathan T Unkart, Jennifer A Padwal, Brian M Ilfeld, Anne M Wallace
OBJECTIVES: The addition of a perioperative continuous paravertebral nerve block (cPVB) to a single-injection thoracic paravertebral nerve block (tPVB) has demonstrated improved analgesia in breast surgery. However, its use following isolated post-mastectomy reconstruction using a latissimus dorsi flap (LDF) has not previously been examined. METHODS: We performed a retrospective review of patients who underwent salvage breast reconstruction with a unilateral LDF by a single surgeon...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27830894/three-concurrent-variations-of-the-aberrant-right-subclavian-artery-the-non-recurrent-laryngeal-nerve-and-the-right-thoracic-duct
#16
Joo-Yeon Lee, Doe-Yoon Won, Sae-Hoon Oh, Sung-Young Hong, Ran-Sook Woo, Tai-Kyoung Baik, Hong-Il Yoo, Dae-Yong Song
We herein report a case showing three anatomical variations including the aberrant right subclavian artery (ARSA), the non-recurrent laryngeal nerve (NRLN) and the right thoracic duct in a 59-year-old male cadaver. The right subclavian artery arose from the descending aorta next to the left subclavian artery and coursed in between the oesophagus and the thoracic vertebrae. The recurrent laryngeal nerve did not coil around the right subclavian artery but directly entered the larynx. Lastly the thoracic duct terminated into the right brachiocephalic vein...
November 10, 2016: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/27830440/surgical-relevance-of-the-lateral-costotransverse-ligament-in-relation-to-the-dorsal-root-ganglion
#17
Anthony V D'Antoni, Peter G Collin, Rachel A Graham, Helena M Kennedy, Tatiana Ndjatou, Pamela Perez, R Shane Tubbs, Marios Loukas, Piotr B Kozlowski, Estomith P Mtui
The lateral costotransverse ligament, a short band that stabilizes the costovertebral joint, is found in close proximity to the dorsal root ganglion. This ligament is an important surgical landmark during tumor resections or nerve blocks in the paravertebral space. The purpose of this study was to quantitatively and qualitatively describe the morphology of the lateral costotransverse ligament and its relation to the dorsal root ganglion at all levels of the thoracic spine. The thoracic spines of eight embalmed cadavers were dissected bilaterally...
November 9, 2016: Anatomical Science International
https://www.readbyqxmd.com/read/27826777/impact-of-routine-recurrent-laryngeal-nerve-monitoring-in-prone-esophagectomy-with-mediastinal-lymph-node-dissection
#18
Makoto Hikage, Takashi Kamei, Toru Nakano, Shigeo Abe, Kazunori Katsura, Yusuke Taniyama, Tadashi Sakurai, Jin Teshima, Soichi Ito, Nobuchika Niizuma, Hiroshi Okamoto, Toshiaki Fukutomi, Masato Yamada, Shota Maruyama, Noriaki Ohuchi
BACKGROUND: The problem of recurrent laryngeal nerve (RLN) paralysis (RLNP) after radical esophagectomy remains unresolved. Several studies have confirmed that intraoperative nerve monitoring (IONM) of the RLN during thyroid surgery substantially decreases the incidence of RLN damage. This study tried to determine the feasibility and effectiveness of IONM of the RLN during thoracoscopic esophagectomy in the prone position for esophageal cancer. METHODS: All 108 patients who underwent prone esophagectomy at Tohoku University Hospital between July 2012 and March 2015 were included in this study...
November 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27818351/intrathoracic-neurogenic-tumor-with-malignant-transition-20-years-operation-experience-in-a-medical-center-of-china
#19
Chenlu Yang, Deping Zhao, Peng Zhang, Ke Fei, Gening Jiang
OBJECTIVE: Malignant peripheral neurogenic tumor is always found in large peripheral nerve of the extremities, however, benign peripheral neurogenic tumors of chest is an uncommon disorder, furthermore, malignant transition is even rare. So far, few cases have been reported. We studied 45 neurogenic thoracic tumors patients with malignant transition. METHODS: We retrospectively reviewed clinical data of 45 malignant neurogenic thoracic tumors from 1992 to 2012, including 11 (24...
November 3, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27811494/successful-treatment-of-persistent-pain-after-pectus-excavatum-repair-using-paravertebral-nerve-radiofrequency-thermoablation
#20
Hannah Noemi Ladenhauf, Ottokar Stundner, Rudolf Likar, Jörg Schnöll, Roman P Metzger
We present a case of a 25-year-old male patient suffering from severe prolonged pain after uneventful pectus excavatum repair that could be treated successfully by paravertebral nerve radiofrequency thermoablation. The patient was scheduled for a minimally invasive Nuss pectus excavatum repair. Surgical correction was performed under general anesthesia in combination with a thoracic peridural catheter. The immediate postoperative course was uneventful; however, the patient developed severe prolonged bilateral chest wall pain across segments T8 and T9...
November 2, 2016: A & A Case Reports
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