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surgery sciatic pain

Wei-Nan Zeng, Jun-Li Liu, Xiao-Lin Jia, Qiang Zhou, Liu Yang, Yun Zhang
BACKGROUND: Total hip arthroplasty (THA) is technically challenging in patients with high dislocation of the hip secondary to suppurative arthritis. The technical difficulty is attributable to the complex hip anatomy and the potential risk of recurrent infection in these patients. This study investigated the midterm results of THA in patients with Crowe type III and IV high dislocation of the hip secondary to suppurative arthritis. METHODS: This study retrospectively reviewed 45 patients (45 hips) who underwent cementless THA with a mean quiescent infection period of 34...
September 27, 2018: Journal of Arthroplasty
Yuji Kasukawa, Naohisa Miyakoshi, Masazumi Suzuki, Hiroyuki Tsuchie, Chie Sato, Tetsuya Kawano, Manabu Akagawa, Yuichi Ono, Yoichi Shimada
We evaluated the analgesic effects of minodronate, alendronate and pregabalin on mechanical and thermal allodynia, as well as changes in bone mineral density and skeletal muscle volume caused by chronic constriction injury (CCI) in an ovariectomized rat. Ovariectomy was performed on four-week-old female Wistar rats. Thereafter, at 8-weeks of age, the left sciatic nerve was ligated to create the chronic pain model (CCI limb), and sham surgery was performed on the right hindlimb. In all rats, either minodronate (0...
2018: Biomedical Research
Simon Heinrich Bayerl, Malte Dinkelbach, Petra Heiden, Vincent Prinz, Tobias Finger, Peter Vajkoczy
PURPOSE: The lumbar epidural lipomatosis (LEL) is a rare disease that can cause sciatic pain syndrome or neurological deficits comparable to symptoms caused by a classical spinal canal stenosis. In severe cases surgical decompression was conducted. However, the outcome after decompressive surgery has only been investigated in small case series. In this study we compared the outcome of LEL patients after microsurgery with the outcome of patients with classical spinal stenosis (CSS). METHODS: Patients with LEL (n = 38) and patients with CSS (n = 51), who received microsurgical decompression, were followed in a prospective observational study for 3 years...
October 1, 2018: European Spine Journal
Byung-Ki Lee, Chang-Ju Kim, Mal-Soon Shin, Young Sam Cho
Peripheral nerve injuries are commonly encountered clinical problem and often result in chronic pain and severe functional deficit. Diosgenin is a plant steroidal saponin and has anti-inflammatory and anticancer effects. In the present study, we investigated the effect of diosgenin on functional recovery following sciatic crushed nerve injury in rats. Walking track analysis for the functional recovery which can be quantified with the sciatic function index (SFI) was conducted. Immunohistochemistry for c-Fos in the ventrolateral periaqueductal gray (vlPAG) and paraventricular nucleus (PVN) and western blot for brain-derived neurotrophic factor (BDNF), tyrosine kinase B (TrkB), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthesis (iNOS) in the sciatic nerve were performed...
August 2018: Journal of Exercise Rehabilitation
Tal D Saar, Stefaan Pacquée, Dean Helmar Conrad, Mikhail Sarofim, Philippe De Rosnay, David Rosen, Greg Cario, Danny Chou
Endometriosis is a common gynecological condition which affects 5-10% of women of reproductive age and up to 50% of women with pelvic pain and infertility. The most commonly affected areas are the pelvic peritoneum, ovaries and rectovaginal septum. Isolated endometriosis of the sciatic nerve is very rare. Our patient suffered from worsening right hip and buttock pain with severe exacerbation during menstruation. Several different imaging modalities (ultrasound of her pelvis and right hip, as well as X-rays and computed tomography scans of her right hip and lumbosacral spine) failed to identify any pathology...
April 2018: Gynecology and minimally invasive therapy
A Nair, J Dolan, K E Tanner, C M Kerr, B Jones, P J Pollock, C F Kellett
BACKGROUND: Placement of local anaesthetic within the adductor canal using ultrasonography is an alternative to femoral nerve blocks for postoperative pain relief after knee joint replacement surgery. However, the effect of an inflated thigh tourniquet on the distribution of local anaesthetic within the adductor canal is unknown. The aim of this cadaveric study was to compare the distribution of radio-opaque dye within the adductor canal in the presence or absence of an inflated thigh tourniquet...
October 2018: British Journal of Anaesthesia
Wei Shu, Haipeng Wang, Hongwei Zhu, Yongjie Li, Jiaxing Zhang, Guang Lu, Bing Ni
CONTEXT: Pseudomeningocele is a relatively uncommon postoperative complication of spine surgery. Although the condition tends to be asymptomatic and self-limiting, it may cause radicular pain and neurological defect due to herniation of the nerve root or the spinal cord. Its pathophysiology remains unclear. Only few cases with intraoperative photos have been reported. FINDING: We present a case of pseudomeningocele with nerve root entrapment after percutaneous endoscopic lumbar discectomy (PELD)...
September 13, 2018: Journal of Spinal Cord Medicine
Meng Zhou, Shuai An, Mingli Feng, Zheng Li, Huiliang Shen, Kuan Zhang, Jun Sun, Guanglei Cao
BACKGROUND: The main objective of total knee arthroplasty is to relieve pain, restore normal knee function, and improve gait stability. Significant flexion contractures can severely impair function after surgery. The purpose of this study is to evaluate the efficacy of implementing a continuous proximal sciatic nerve block in conjunction with aggressive physical therapy to treat patients with persistent flexion contractures that were recalcitrant to rehabilitation efforts following primary total knee arthroplasty (TKA)...
October 2018: Gait & Posture
Martin J Wilby, Carolyn Hopkins, Emma Bedson, Sue Howlin, Girvan Burnside, Elizabeth J Conroy, Dyfrig A Hughes, Manohar Sharma, Anthony Marson, Simon R Clark, Paula Williamson
BACKGROUND: Sciatica is a common condition reported to affect over 3% of the UK population at any time and is often caused by a prolapsed intervertebral disc (PID). Although the duration and severity of symptoms can vary, pain persisting beyond 6 weeks is unlikely to recover spontaneously and may require investigation and treatment. Currently, there is no specific care pathway for sciatica in the National Health Service (NHS), and no direct comparison exists between surgical microdiscectomy and transforaminal epidural steroid injection (TFESI)...
September 5, 2018: Trials
Pawan Agarwal, Piyush Shukla, D Sharma
BACKGROUND: Loss of protective sensation of the sole may lead to repeated trauma, chronic nonhealing ulcers, and even amputation. Saphenous nerve (SN) to posterior tibial nerve (PTN) transfer can restore sensation of the sole. METHOD: This study was conducted in a tertiary referral center in Central India. Twenty-one patients (32 feet) diagnosed with loss of sensation of the sole were included in this study. Causes of loss of sensation were Hansen's disease (n = 18), complex sciatic nerve injury (n = 1), lumbosacral spinal tumor (n = 1), and lumbosacral meningomyelocele (n = 1)...
August 2, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Hsiao-Chun Lin, Chen-Tung Yen
Neuropathic pain is due to lesion or dysfunction of the somatosensory system. Treating patients with neuropathic pain is difficult because the underlying mechanisms are understood limitedly, especially at the supraspinal level. In this study, we used two kinds of molecular markers to investigate the neuronal activity changes in the anterior cingulate cortex, insular cortex (IC), and medial prefrontal cortex (mPFC) of the neuropathic rats under tactile allodynia. We used spared nerve injury of the sciatic nerve (SNI) as the neuropathic pain model...
August 31, 2018: Chinese Journal of Physiology
Jacklynn F Sztain, John J Finneran, Amanda M Monahan, Bahareh Khatibi, Patrick L Nguyen, Sarah J Madison, Richard H Bellars, Rodney A Gabriel, Sonya S Ahmed, Alexandra K Schwartz, William T Kent, Michael C Donohue, Jennifer A Padwal, Brian M Ilfeld
We tested the hypothesis that during a continuous popliteal-sciatic nerve block, postoperative analgesia is improved with the catheter insertion point "deep" to the paraneural sheath immediately distal to the bifurcation between the tibial and common peroneal branches, compared with the traditional approach "superficial" to the paraneural sheath proximal to the bifurcation. The needle tip location was determined to be accurately located with a fluid bolus visualized with ultrasound; however, catheters were subsequently inserted without a similar fluid injection and visualization protocol (visualized air injection was permitted and usually implemented, but not required per protocol)...
August 9, 2018: Anesthesia and Analgesia
Qiang Wu, Li Liu
Opioid receptor like 1 (ORL1 ) receptor activation displayed an anti-nociceptive effect at spinal level for acute and neuropathic pain. SCH221510, an orally active non-peptide ORL1 agonist, was reported to be effective in treating neuropathic pain. The present study used ORL1 antagonist and siRNA to investigate that ORL1 activation mediates intrathecal SCH221510 analgesia in neuropathic pain induced by chronic constrictive injury (CCI) to rat sciatic nerve. Paw withdrawal latency and 50% mechanical threshold were measured for thermal and mechanical hypersensitivity in rats...
September 2018: Journal of Molecular Neuroscience: MN
Sandra Velcic Brumnjak, Ivan Rakovac, Dijana Papez Kinkela, Kresimir Bukal, Branko Sestan, Vera Tulic, Elisa Velcic Janjetic, Vlatka Sotosek Tokmadzic
BACKGROUND Pain and surgical stress cause a pro-inflammatory response followed by downregulation of the immune response, which can increase the incidence of postoperative complications, such as infections or prolonged wound healing. T lymphocytes and natural killer (NK) cells have cytotoxic potential and are crucial components of cellular immunity, which is important for maintenance of immune balance. The aim of this study was to analyze the effects of 3 types of postoperative analgesia on the preservation and cytotoxic potential of T lymphocytes, NK cells, and their subpopulations, as well as NKT cells, in patients after total knee replacement (TKR) to find the most effective analgesic technique for mitigating immune suppression...
July 31, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Rhian Alice Ceredig, Florian Pierre, Stéphane Doridot, Unai Alduntzin, Eric Salvat, Ipek Yalcin, Claire Gaveriaux-Ruff, Michel Barrot, Dominique Massotte
Peripheral delta opioid (DOP) receptors are essential for the antiallodynic effect of the tricyclic antidepressant nortriptyline. However, the population of DOP-expressing cells affected in neuropathic conditions or underlying the antiallodynic activity of antidepressants remains unknown. Using a mouse line in which DOP receptors were selectively ablated in cells expressing Nav1.8 sodium channels (DOP cKO), we established that these DOP peripheral receptors were mandatory for duloxetine to alleviate mechanical allodynia in a neuropathic pain model based on sciatic nerve cuffing...
September 2018: European Journal of Neuroscience
Li Zhan, Rui Li, Yuhong Sun, Mengyun Dou, Wan Yang, Shufang He, Ye Zhang
The therapeutic effects of mitochondria-targeted antioxidants have been demonstrated in many pathological conditions, but their effect on neuropathic pain remains unclear. The objective was to study the therapeutic effects and mechanisms of mito-TEMPO (MT), as a nitroxide conjugated with a triphenylphosphonium moiety, on neuropathic pain in rats. Rats were randomly assigned to sham control (sham), chronic constrictive injury (CCI) or MT treatment groups (sham+MT and CCI+MT). All animals received CCI of the left sciatic nerve except those in the sham group...
October 17, 2018: Neuroreport
M T Berninger, J Friederichs, W Leidinger, P Augat, V Bühren, C Fulghum, W Reng
BACKGROUND: The aim of the study was to analyze the effect of local infiltration analgesia (LIA), peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary unicompartmental knee arthroplasty (UKA). METHODS: Between January 2016 until August 2016, 134 patients underwent primary UKA and were subdivided into four groups according to their concomitant pain and anesthetic procedure with catheter-based techniques of femoral and sciatic nerve block (group GA&FNB, n = 38) or epidural catheter (group SP&EPI, n = 20) in combination with general anesthesia or spinal anesthesia, respectively, and LIA combined with general anesthesia (group GA&LIA, n = 46) or spinal anesthesia (group SP&LIA, n = 30)...
July 24, 2018: BMC Musculoskeletal Disorders
Brian M Ilfeld, Scott T Ball, Rodney A Gabriel, Jacklynn F Sztain, Amanda M Monahan, Wendy B Abramson, Bahareh Khatibi, Engy T Said, Jesal Parekh, Stuart A Grant, Amorn Wongsarnpigoon, Joseph W Boggs
INTRODUCTION: The objective of the present feasibility study was to investigate the use of a new treatment modality-percutaneous peripheral nerve stimulation (PNS)-in controlling the often severe and long-lasting pain following total knee arthroplasty (TKA). METHODS: For patients undergoing a primary, unilateral TKA, both femoral and sciatic open-coil percutaneous leads (SPR Therapeutics, Cleveland, OH) were placed up to seven days prior to surgery using ultrasound guidance...
July 19, 2018: Neuromodulation: Journal of the International Neuromodulation Society
M T Berninger, J Friederichs, W Leidinger, P Augat, V Bühren, C Fulghum, W Reng
BACKGROUND: Postoperative pain control and enhanced mobilization, muscle strength and range of motion following total knee arthroplasty (TKA) are pivotal requisites to optimize rehabilitation and early recovery. The aim of the study was to analyze the effect of local infiltration analgesia (LIA), peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary total knee arthroplasty. METHODS: Between January 2016 until August 2016, 280 patients underwent primary TKA and were subdivided into four groups according to their concomitant pain and anesthetic procedure with catheter-based techniques of femoral and sciatic nerve block (group GA&FNB, n = 81) or epidural catheter (group SP&EPI, n = 51) in combination with general anesthesia or spinal anesthesia, respectively, and LIA combined with general anesthesia (group GA&LIA, n = 86) or spinal anesthesia (group SP&LIA, n = 61)...
July 18, 2018: BMC Musculoskeletal Disorders
Wei-Qiang Chen, Na Guo, Shan-Shan Wang, Ren Wang, Fei Huang, Shang-Rong Li
OBJECTIVE: To compare the perioperative outcomes and hemodynamic effects at induction of general laryngeal mask airway (LMA) anesthesia with lumbar plexus-sciatic nerve block (LPSB) and general anesthesia with endotracheal intubation (ET) in elderly patients undergoing hip surgery. METHODS: A total of 63 patients having open reduction internal fixation of an intertrochanteric fracture were randomly assigned to receive LMA anesthesia with LPSB or general anesthesia with ET...
September 2018: Archives of Gerontology and Geriatrics
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