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Utsav Bansal, Thomas W Fuller, Xuewen Jiang, Jathin Bandari, Zhaocun Zhang, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
AIMS: To determine the spinal segmental afferent contributions to tibial and pudendal inhibition of bladder overactivity. METHODS: Intravesical infusion of 0.5% acetic acid was used to irritate the bladder and induce bladder overactivity in anesthetized cats. Tibial or pudendal nerve stimulation was used to suppress the bladder overactivity and increase bladder capacity during cystometry. L5-S3 dorsal roots ipsilateral to the stimulation were exposed by a laminectomy and transected sequentially during the experiments to determine the role of individual dorsal roots in tibial or pudendal neuromodulation...
October 24, 2016: Neurourology and Urodynamics
Jaya Uppal, Stanislaw Sobotka, Arthur L Jenkins
BACKGROUND: Multiple causes outside the spine can mimic spinal back pain. Endometriosis is an important gynecological disorder, which commonly affects the lower region of the female pelvis and less frequently the spine and soft tissues. The lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Therefore symptoms of endometriosis include severe reoccurring pain in the pelvic area as well as lower back and abdominal pain. CASE DESCRIPTION: We report on a 39 year old gymnast with cyclic sciatica and back pain, whose initial presentation initially led to a spinal fusion at L4/5 and L5/S1, but that procedure did not change her symptoms...
October 21, 2016: World Neurosurgery
Alexander A Theologis, Gregory M Mundis, Stacie Nguyen, David O Okonkwo, Praveen V Mummaneni, Justin S Smith, Christopher I Shaffrey, Richard Fessler, Shay Bess, Frank Schwab, Bassel G Diebo, Douglas Burton, Robert Hart, Vedat Deviren, Christopher Ames
OBJECTIVE The aim of this study was to evaluate the utility of supplementing long thoracolumbar posterior instrumented fusion (posterior spinal fusion, PSF) with lateral interbody fusion (LIF) of the lumbar/thoracolumbar coronal curve apex in adult spinal deformity (ASD). METHODS Two multicenter databases were evaluated. Adults who had undergone multilevel LIF of the coronal curve apex in addition to PSF with L5-S1 interbody fusion (LS+Apex group) were matched by number of posterior levels fused with patients who had undergone PSF with L5-S1 interbody fusion without LIF (LS-Only group)...
October 21, 2016: Journal of Neurosurgery. Spine
Giancarlo D'Andrea, Giovanni Sessa, Veronica Picotti, Antonino Raco
We report the case of a large lumbar schwannoma eroding the vertebra and originating from spinal canal with invasion of the retroperitoneal space. We also review all the cases in literature reporting lumbar schwannomas eroding the vertebral bodies and invading the retroperitoneal space focusing on the surgical strategies to manage them. Spinal CT-scan revealed a 44 mm × 55 mm inhomogeneous soft-tissue mass arising from the right L5-S1 neural foramen and its most anterior portion had a clear colliquative aspect...
2016: Case Reports in Surgery
Evgenii Belykh, Alexander V Krutko, Evgenii S Baykov, Morgan B Giers, Mark C Preul, Vadim A Byvaltsev
BACKGROUND CONTEXT: Recurrence of lumbar disc herniation (rLDH) is one of the unfavorable outcomes after microdiscectomy. Prediction of the patient population with increased risk of rLDH is important because patients may benefit from preventive measures or other surgical options. PURPOSE: The study assessed preoperative factors associated with rLDH after microdiscectomy and created a mathematical model for estimation of chances for rLDH. STUDY DESIGN/SETTING: This is a retrospective case-control study...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Gregory G Billy, Ji Lin, Mengzhao Gao, Mosuk X Chow
STUDY DESIGN: Retrospective clinical outcome analysis. OBJECTIVE: To evaluate and determine whether demographic, comorbid factors, or physical examination findings may predict the outcome of caudal epidural steroid injections in managing patients with chronic low back pain and radiculopathy SUMMARY OF BACKGROUND DATA:: The caudal epidural approach is commonly utilized with patients who are on anticoagulation or who have had prior lumbar surgery to treat L5 or S1 radiculopathies...
October 19, 2016: Clinical Spine Surgery
Ru-Sen Zhu, Yi-Ming Ren, Jian-Jun Yuan, Zi-Jian Cui, Jun Wan, Bao-You Fan, Wei Lin, Xian-Hu Zhou, Xue-Li Zhang
Lumbar disc herniation (LDH) is a common disease and lumbar discectomy is the most common surgical procedure carried out for patients with low back pain and leg symptoms. Although most researchers are focusing on the surgical techniques during operation, the aim of this study is to evaluate the effect of local intervertebral lavage during microdiscectomy.In this retrospective study, 410 patients were operated on by microdiscectomy for LDH during 2011 to 2014. Retrospectively, 213 of them (group A) accepted local intervertebral irrigation with saline water before wound closure and 197 patients (group B) only had their operative field irrigated with saline water...
October 2016: Medicine (Baltimore)
Shiro Imagama, Noriaki Kawakami, Yuji Matsubara, Taichi Tsuji, Tetsuya Ohara, Yoshito Katayama, Naoki Ishiguro, Tokumi Kanemura
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To investigate adjacent segment degeneration (ASD) at 5 years after L4/5 posterior lumbar interbody fusion with pedicle screw instrumentation and L4/5 decompression surgery using plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI), with the evaluation of annual changes on MRI. SUMMARY OF BACKGROUND DATA: Methods of evaluation have been inconsistent among studies of ASD...
November 2016: Clinical Spine Surgery
Qing Yue, Tyson Hale, Aaron Knecht, Jennifer Laidacker
BACKGROUND: Foot drop secondary to L5 root injury is a rare complication associated with lumbar surgery. To date, it is still not clear whether intraoperative neuromonitoring can detect such an injury. CASE DESCRIPTION: A 54-year-old man who had had bilateral chronic L5 radiculopathy underwent L4-S1 lumbosacral decompression and fusion. During the surgery, the patient lose transcranial electrical motor evoked potential (tceMEPs) from left tibialis anterior (TA) at the time of L5-S1 intervertebral cage placement...
October 14, 2016: World Neurosurgery
Trevor J G Robinson, Shannon L Roberts, Robert S Burnham, Eldon Loh, Anne M Agur
Image-guided sensory block and radiofrequency ablation of the nerves innervating the sacro-iliac joint require readily identifiable bony landmarks for accurate needle/electrode placement. Understanding the relative locations of the transverse sacral tubercles along the lateral sacral crest is important for ultrasound guidance, as they demarcate the position of the posterior sacral network (S1-S3 ± L5/S4) innervating the posterior sacro-iliac joint. No studies were found that investigated the spatial relationships of these bony landmarks...
2016: BioMed Research International
Edvin Zekaj, Claudia Menghetti, Christian Saleh, Alessandra Isidori, Alberto R Bona, Enrico Aimar, Domenico Servello
BACKGROUND: Intraforaminal disc herniations at the L5-S1 level are extremely surgically challenging lesions. Intracanal approaches frequently require partial or total facetectomy, which may lead to instability. Solely extraforaminal approaches may offer limited visualization of the more medial superiorly exiting and inferiorly exiting nerve roots; this approach is also more complicated at L5-S1 due to the often large L5 transverse process and the iliac wing. METHODS: Nine patients with intraforaminal L5-S1 disc herniations, foraminal stenosis, or synovial cysts underwent contralateral interlaminar approaches for lesion resection...
2016: Surgical Neurology International
F Ghezelbash, A Shirazi-Adl, N Arjmand, Z El-Ouaaid, A Plamondon, J R Meakin
Subject-specific parameters influence spinal loads and the risk of back disorders but their relative effects are not well understood. The objective of this study is to investigate the effects of changes in age (35-60 years), sex (male, female), body height (BH: 150-190cm) and body weight (BW: 50-120kg) on spinal loads in a full-factorial simulation using a personalized (spine kinematics, geometry, musculature and passive properties) kinematics driven musculoskeletal trunk finite element model. Segmental weight distribution (magnitude and location along the trunk) was estimated by a novel technique to accurately represent obesity...
October 3, 2016: Journal of Biomechanics
Anna Maria Ierardi, Filippo Piacentino, Francesca Giorlando, Alberto Magenta Biasina, Alessandro Bacuzzi, Raffaele Novario, Gianpaolo Carrafiello
OBJECTIVE: To demonstrate the feasibility of percutaneous nucleoplasty procedures at L5/S1 level using cone beam CT (CBCT) and its associated image guidance technology for the treatment of lumbar disc herniation (LDH). MATERIALS AND METHODS: We retrospectively reviewed 25 cases (20 men, 5 women) of LDH at L5/S1 levels. CBCT as guidance imaging was chosen after a first unsuccessful fluoroscopy attempt that was related to complex anatomy (n = 15), rapid pathological changes due to degenerative diseases (n = 7) or both (n = 3)...
October 3, 2016: Skeletal Radiology
Suzi Edwards, Hiram C Brooke, Jill L Cook
OBJECTIVES: This study aimed to explore the differences in the magnitude of movement variability and strategies utilized during an unanticipated cut task between players with and without a history of groin pain. DESIGN: Cross-sectional design. SETTING: Biomechanics laboratory. PARTICIANTS: Male Australian football players with (HISTORY; n = 7) or without (CONTROL; n = 10) a history of groin pain. OUTCOME MEASURES: Three-dimensional ground reaction forces (GRF) and kinematics were recorded during 10 successful trials of an unanticipated cut task, and isokinetic hip adduction and abduction strength...
July 22, 2016: Physical Therapy in Sport
Liehua Liu, Yong Liang, Hong Zhang, Haoming Wang, Congtao Guo, Xiaobing Pu, Chengmin Zhang, Liyuan Wang, Jian Wang, Yingwen Lv, Zhoukui Ren, Qiang Zhou, Zhongliang Deng
To provide applied anatomical evidence of the preoperative assessment of oblique lumbar interbody fusion (OLIF), the anatomical parameters of the OLIF operative window were observed through computed tomography angiography (CTA). We selected imaging data from 60 adults (30 males, 30 females) who underwent abdominal CTA and T12-S1 vertebral computed tomography (CT) with three-dimensional reconstruction. The OLIF operative windows at the L1-2, L2-3, L3-4, L4-5 and L5-S1 levels were as follows: the vascular window, bare window, psoas major window, ideal operative window, and actual operative window...
2016: PloS One
Peter T McCunniff, Hojun Yoo, Charles Yu, Navkirat S Bajwa, Jason O Toy, Uri M Ahn, Nicholas Ahn
This study examined the effect of bilateral and unilateral L5 pars defects on the degree of disk degeneration at the L5-S1 level in cadaveric specimens. An observational study was performed of 690 cadaveric specimens selected at random. These specimens represent individuals who died between 1893 and 1938. The study included 558 male and 132 female cadavers. Of the 120 specimens with L5 spondylolysis, 95 cases were bilateral and 25 were unilateral. The remaining 544 specimens were used as the control cohort...
September 29, 2016: Orthopedics
Fangzhi Jia, Ralph J Mobbs, Kevin Phan
No abstract text is available yet for this article.
December 2015: J Spine Surg
Daniele Vanni, Renato Galzio, Anna Kazakova, Matteo Guelfi, Andrea Pantalone, Vincenzo Salini, Vincenzo Magliani
Lumbar disk herniation (LDH) is a degenerative pathology. Although LDH generally occurs without migration of the fragment to the levels above or below, in 10% of the cases, this circumstance might happen. In these cases, the standard interlaminar approach, described by Caspar cannot be performed without laminotomies, interlaminectomies, or partial or total facetectomies. The translaminar approach is the only "tissue-sparing" technique viable in cases of cranially migrated LDH encroaching on the exiting nerve root in the preforaminal zones, for the levels above L2-L3, and in the preforaminal and foraminal zones, for the levels below L3-L4 (L5-S1 included, if a total microdiscectomy is unnecessary)...
December 2015: J Spine Surg
Weibo Pan, Bin Feng, Zhan Wang, Nong Lin, Zhaoming Ye
PURPOSE: Malignant peripheral nerve sheath tumors are extremely rare in the general population and display a predilection for metastasis to the lungs. Here, we present a rare case of a malignant peripheral nerve sheath tumor located in the paraspinal region and highlight the importance of preoperative biopsy in diagnosis of spinal epidural peripheral nerve sheath tumors. METHODS: We describe the clinical course of the patient as well as the radiological and pathological findings of the tumor...
September 27, 2016: European Spine Journal
Alan H Daniels, Heiko Koller, Shannon L Hiratzka, Michael Mayer, Oliver Meier, Alec Gabriel Contag, Adam E M Eltorai, Jayme Hiratzka, D Kojo Hamilton, Christopher I Shaffrey, Justin S Smith, Shay Bess, Eric O Klineberg, Christopher P Ames, Virginie Lafage, Breton Line, Frank J Schwab, Robert A Hart, International Spine Study Group
PURPOSE: Controversy persists as to whether to end multilevel thoracolumbar fusions caudally at L5 or S1. Some argue that stopping at L5 may preserve greater function, but there are few data comparing functional limitations due to lumbar stiffness in patients with fusion to L5 versus S1. The aim of this study was to evaluate whether patients undergoing multilevel thoracolumbar fusions with an L5 caudal endpoint have a better lumbosacral function than patients with an S1 caudal endpoint...
September 27, 2016: European Spine Journal
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