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Lumbar epidural

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https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#1
Christopher G Gharibo, Michael Fakhry, Sudhir Diwan, Alan D Kaye
BACKGROUND: For decades, epidural steroid injections have been an effective tool in the management of many pain related conditions, including lumbar radiculopathy. Transforaminal epidural steroid injections in particular have been reported to potentially result in central nervous system infarctions which have not been reported with interlaminar epidural steroid injections, while providing comparable efficacy. This rare, catastrophic complication has been attributed by some authors to be due to vascular injury secondary to vasospasm, thrombus formation, dissection, as well as concerns with placing the needle at the so-called "safe triangle...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906951/changes-in-neuroglial-activity-in-multiple-spinal-segments-after-caudal-epidural-pulsed-radiofrequency-in-a-rat-model-of-lumbar-disc-herniation
#2
Hee Kyung Cho, Jae Hoon Kang, So-Yeon Kim, Mi-Jung Choi, Se Jin Hwang, Yun-Woo Cho, Sang-Ho Ahn
BACKGROUND: Herniated lumbar discs can induce sciatica by mechanical compression and/or chemical irritation. It was recently reported that neuroglial cellular activity after pulsed radiofrequency (PRF) application to a single dorsal root ganglion (DRG) attenuated neuroglial activity at the corresponding spinal dorsal horn. Recently, caudal epidural PRF has been used to manage neuropathic pain, but evidence of molecular changes after the administration of caudal epidural PRF to attenuate neuropathic pain is lacking, and it has not been determined whether caudal epidural PRF affects neuroglial activity at different spinal levels...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906944/the-safety-of-ct-guided-epidural-steroid-injections-in-an-older-patient-cohort
#3
Andrew J Fenster, Kevin Fernandes, Alan L Brook, Todd Miller
BACKGROUND: Epidural steroid injections (ESIs) are a common method for treating lower back pain, which is one of the most prevalent health-related complaints in the adult US population. Although the safety of CT-guided ESIs has been extensively studied in adults, there is limited data concerning the procedure's safety profile in an older patient population. OBJECTIVE: This retrospective study analyzed safety data among a single-center cohort of patients > 65 years-old who received one or more CT-guided interlaminar ESIs from 2012 to 2015...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27903338/-ultrasound-imaging-increases-first-attempt-success-rate-of-neuraxial-block-in-elderly-patients
#4
J Geng, X L Chen, X D Wang, X Y Guo, M Li
Objective: To verify whether preprocedural ultrasound of the lumbar spine could improve first-attempt success rate (defined as a successful neuraxial anesthesia with only one skin puncture) of neuraxial block in elderly patients. Methods: From septemble 2015 to February 2016, 200 elderly patients undergoing lower-limb surgery with neuraxial block at the Peking Universty Third Hospital were enrolled in this study.RandA 1.0 software was used to randomize patients into two groups: conventional surface landmark-guided group (group LM) and ultrasound-assisted group (group US)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27898479/the-effect-of-skin-pressure-on-needle-entry-point-accuracy-during-fluoroscopically-guided-lumbar-transforaminal-epidural-injections-a-randomized-clinical-trial
#5
Soon Young Yun, Duck Mi Yoon, Kyung Bong Yoon, Ji Ae Moon, Shin Hyung Kim
OBJECTIVE: The aim of this study was to investigate the effect of skin pressure on needle entry point accuracy during fluoroscopically guided lumbar transforaminal epidural injection. DESIGN: This study is a prospective randomized clinical trial; 64 patients with a body mass index of 25 kg/m or greater were enrolled. For patients in the pressing group, the operator marked the needle entry point on the patient's back while pressing the patient's skin with the tip of an indicator...
November 24, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27896193/multidisciplinary-approach-to-an-extended-pressure-sore-at-the-lumbosacral-area
#6
Sehoon Yoon, Euicheol Jeong, Hudson Alex Lázaro
A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. A 43-year-old female patient with a complicated sore with deep tissue infection had a presacral abscess, an iliopsoas abscess, and an epidural abscess in the lumbar spine. After a multidisciplinary approach performed in stages, the infection had subsided and removal of the devitalized tissue was possible...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27891035/intradiscal-and-intra-articular-facet-infiltrations-with-plasma-rich-in-growth-factors-reduce-pain-in-patients-with-chronic-low-back-pain
#7
Fernando Kirchner, Eduardo Anitua
CONTEXT: Low back pain (LBP) is a complex and disabling condition, and its treatment becomes a challenge. AIMS: The aim of our study was to assess the clinical outcome of plasma rich in growth factors (PRGF-Endoret) infiltrations (one intradiscal, one intra-articular facet, and one transforaminal epidural injection) under fluoroscopic guidance-control in patients with chronic LBP. PRGF-Endoret which has been shown to be an efficient treatment to reduce joint pain...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27890759/transforaminal-percutaneous-endoscopic-lumbar-discectomy-with-percutaneous-epidural-neuroplasty-in-lumbar-disc-herniation-technical-note
#8
Hyeong-Jin Lee, Jin-Sung Kim, Kyeong-Sik Ryu
OBJECTIVE: Percutaneous endoscopic lumbar discectomy and percutaneous epidural neuroplasty is a commonly used minimally invasive spinal surgery in lumbar disc herniation. But to our knowledge, there is no report about the results of percutaneous endoscopic lumbar discectomy with percutaneous epidural neuroplasty. We did this study to evaluate the effect of percutaneous endoscopic lumbar discectomy with percutaneous epidural neuroplasty in lumbar disc herniation. METHODS: We report the series of cases about technics and results of percutaneous endoscopic lumbar discectomy with percutaneous epidural neuroplasty in lumbar disc herniation...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27890757/percutaneous-endoscopic-removal-of-a-lumbar-epidural-angiolipoma-via-interlaminar-approach-a-technical-report
#9
Guang-Yu Ying, Ying Yao, Fang Shen, Yu-Cheng Ren, Chien-Min Chen, Yong-Jian Zhu
BACKGROUND: Percutaneous endoscopic technique has been routinely used in the treatment of disk herniation while there are few reports on its application in the management of intraspinal tumors. We presented here the first case report of lumbar epidural angiolipoma that was totally removed by percutaneous endoscopy. CASE DESCRIPTION: A 63-year-old man presented with 4-month history of progressively worsening low back pain was admitted to our hospital. No abnormal neurological finding was noticed on physical examination and magnetic resonance imaging demonstrated a dorsally located L2-L3 epidural lesion, suggestive of a non-infiltrating angiolipoma...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27879512/uhmwpe-sublaminar-wires-in-posterior-spinal-instrumentation-stability-and-biocompatibility-assessment-in-an-ovine-pilot-study
#10
Rob Bogie, Laura Voss, Jacobus J Arts, Arno Lataster, Paul C Willems, Boudewijn Brans, Lodewijk W van Rhijn, Tim J M Welting
STUDY DESIGN: An animal study. OBJECTIVE: To explore ultra-high molecular weight polyethylene (UHMWPE) sublaminar wires in spinal surgery and to assess stability and biocompatibility of the UHMWPE instrumentation in an ovine model. SUMMARY OF BACKGROUND DATA: Sublaminar wiring is a well-established technique in segmental scoliosis surgery. However, during introduction and/or removal of the metal sublaminar wires, neurological problems can occur...
December 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27858682/the-effectiveness-of-transforaminal-epidural-steroid-injections-on-radicular-pain-functionality-psychological-status-and-sleep-quality-in-patients-with-lumbar-disc-herniation
#11
Mustafa Akif Sariyildiz, İbrahim Batmaz, Levent Yazmalar, Mehmet Güneş, Yahya Turan
BACKGROUND: The significance of fluoroscopy-guided transforaminal epidural steroid injections (TFESI) in the treatment of lumbar disc herniation (LDH) is well known. The aim of our study is to investigate the effectiveness of TFESI on radicular pain, functionality, psychological status, and sleep quality in patients with LDH. METHODS: Seventy-five LDH patients (36 males, 39 females) were enrolled in the study. All patients received a fluoroscopically guided TFESI (betamethasone 40 mg, lidocaine 2%)...
November 8, 2016: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/27852462/ryszard-rodzinski-a-forgotten-polish-inventor-and-pioneer-of-combined-spinal-epidural-anesthesia
#12
REVIEW
Andrzej R Daszkiewicz, Maja M Copik, Hanna D Misiolek, Wojciech Z Reiss
Dr. Ryszard Rodzinski was a Polish surgeon who, in spite of his short life, had a productive career. His most important discovery was a safer method of performing regional anesthesia for abdominal surgery. The first description of combined spinal epidural anesthesia is generally attributed to Soresi in 1937. In the early 20th century, Rodzinski invented a novel technique, "combined lumbosacral anesthesia," which combined lumbar spinal anesthesia and sacral epidural anesthesia. During the 19th Meeting of Polish Surgeons in July 1922 in Warsaw, Rodzinski presented an article entitled "On Combined Lumbosacral Anaesthesia," in which he described this technique used in surgical clinic in Lwów since October 1921...
October 2016: Journal of Anesthesia History
https://www.readbyqxmd.com/read/27852325/salvianolic-acid-b-reduced-the-formation-of-epidural-fibrosis-in-an-experimental-rat-model
#13
Feng Chen, Changyao Wang, Jintang Sun, Jin Wang, Lanfeng Wang, Jianmin Li
BACKGROUND: Salvianolic acid B (Sal B) was newly reported to be able to attenuate fibrosis in the animal model. The aim of the present study was to investigate the effect of the intragastric application of Sal B on the prevention of epidural fibrosis (EF). METHODS: Forty healthy adult male Wistar rats were divided into four treatment groups (n = 10 per group): (1) 10 mg/kg Sal B, (2) 30 mg/kg Sal B, (3) 50 mg/kg Sal B and (4) Saline (vehicle treatment, control group)...
November 16, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27847727/acute-paraplegia-after-lumbar-steroid-injection-in-patients-with-spinal-dural-arteriovenous-fistulas-case-reports
#14
Sunwoong Kim, Yuseong Choi, Jinyoung Park, Duk Hyun Sung
Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal vascular malformations. However, SDAVFs are still underdiagnosed entities because their clinical symptoms are usually non-specific, as they include low back pain or radiating pain to the limb. There have been several reports of acute paraplegia after lumbar epidural steroid injections in patients with SDAVFs. We present 4 patients with SDAVFs who received lumbar steroid injection. Among the 4 cases, acute paraplegia developed in 2 cases that received a larger volume of injectate than the other cases...
October 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27843772/long-term-evaluation-of-continuous-epidural-anesthesia-in-an-improved-canine-model
#15
Kyoko Sasauchi, Katsuhisa Sunada, Tatsuo Nakamura
BACKGROUND: Continuous epidural analgesia with catheterization is a useful technique, because it has a wide adaptation range and provides prolonged analgesia. Problems that may arise from long-term epidural analgesia are changes in the analgesic area, duration of analgesia and catheter-related problems. Few articles have evaluated gradual changes of long-term epidural analgesia. In the animal models used in those studies, the catheter was inserted by an invasive surgical procedure. In the present study, we evaluated changes in a canine model in which the catheter was inserted by a minimally invasive procedure...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27830790/a-brain-spine-interface-alleviating-gait-deficits-after-spinal-cord-injury-in-primates
#16
Marco Capogrosso, Tomislav Milekovic, David Borton, Fabien Wagner, Eduardo Martin Moraud, Jean-Baptiste Mignardot, Nicolas Buse, Jerome Gandar, Quentin Barraud, David Xing, Elodie Rey, Simone Duis, Yang Jianzhong, Wai Kin D Ko, Qin Li, Peter Detemple, Tim Denison, Silvestro Micera, Erwan Bezard, Jocelyne Bloch, Grégoire Courtine
Spinal cord injury disrupts the communication between the brain and the spinal circuits that orchestrate movement. To bypass the lesion, brain-computer interfaces have directly linked cortical activity to electrical stimulation of muscles, and have thus restored grasping abilities after hand paralysis. Theoretically, this strategy could also restore control over leg muscle activity for walking. However, replicating the complex sequence of individual muscle activation patterns underlying natural and adaptive locomotor movements poses formidable conceptual and technological challenges...
November 9, 2016: Nature
https://www.readbyqxmd.com/read/27821273/characteristics-of-thoracic-and-lumbar-movements-during-gait-in-lumbar-spinal-stenosis-patients-before-and-after-decompression-surgery
#17
Wataru Kuwahara, Masataka Deie, Naoto Fujita, Nobuhiro Tanaka, Kazuyoshi Nakanishi, Toru Sunagawa, Makoto Asaeda, Haruka Nakamura, Yoshifumi Kono, Mitsuo Ochi
BACKGROUND: Although gait analysis has been previously conducted for lumbar spinal stenosis patients, the vertebral segmental movements, such as of the thoracic and lumbar regions, and whether the spinal movement during gait changes after decompression surgery remain unclear. METHODS: Ten patients with lumbar spinal stenosis and 10 healthy controls participated. Clinical outcomes were assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and Visual Analogue Scale...
October 29, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/27818870/spontaneous-chronic-epidural-hematoma-in-the-lumbar-spine-associated-with-warfarin-intake-a-case-report
#18
Axel Sandvig, Håkan Jonsson
INTRODUCTION: Spontaneous spinal epidural hematomas are rare. However, in patients on anticoagulant treatment the risk may increase. Symptomatically patients may present with radiculopathy and even progressive neurological deficits. CASE DESCRIPTION: We present a case of a warfarin treated patient with left L5 radiculopathy. MRI was evaluated as showing a lumbar disc prolapse or synovial cyst at L4-L5 level. The patient was operated and an organized material was removed and analysed as a hematoma...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27815809/prevalence-of-thoracic-spine-lesions-masquerading-as-cauda-equina-syndrome-yield-of-a-novel-magnetic-resonance-imaging-protocol
#19
Katherine Stolper, James Clark Haug, Chad Todd Christensen, Kathleen Michelle Samsey, Michael David April
Our objective was to describe the yield of actionable thoracic spine lesions for a novel magnetic resonance imaging (MRI) protocol including evaluation of the thoracic spine among patients presenting to the Emergency Department (ED) with symptoms consistent with epidural compression syndrome. Our ED and Department of Radiology together designed a novel rapid MRI protocol entailing 3D volumetric T2 weighted sequences through both the thoracic and lumbar spine obtained in the sagittal plane to assess for both lumbar and thoracic spine lesions...
November 4, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27813034/-horner-syndrome-following-combined-spinal-epidural-anesthesia
#20
Ömer Karaca, Sezen Kumaş Solak, Serdar Demirgan, Mehmet Bademci
Horner syndrome is rarely observed in connection with epidural anesthesia. It is characterized by ptosis, enophthalmos, miosis, anisocoria, and conjunctival hyperemia in the affected eye, as well as anhydrosis and flushing on the affected side of the face. It is usually a complication spontaneously resolved without permanent neurological deficits. Intraoral anesthesia; stellate ganglion, cervical or brachial plexus blocks; thoracic, lumbar or caudal epidural anesthesia, and intrapleural analgesia are the main causes for Horner syndrome related to anesthesia...
July 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
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