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lumbar veins

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
P Di Cello, S Izzo, F Pugliese, I Di Poce, A Orsini, L Izzo, G Mazzone, F Biancucci, G Sinaimeri, S Valabrega, M Almansour, P Izzo
This case report is about a 70-years-old female patient, suffering from discal hernia, with compression of the iliac vein, that led to the formation of deep vein thrombosis of the lower limbs. The angio-CT scan revealed the starting point of the L4- L5 compression where a voluminous discal hernia caused deep vein thrombosis, with the involvement the femoro-popliteal venous axis. Blood samples and PET-CT scans excluded other possible etiologic factors. This case demonstrates how a voluminous discal hernia can cause venous thrombosis...
May 2016: Il Giornale di Chirurgia
Darnell T Josiah, SoHyun Boo, Abdul Tarabishy, Sanjay Bhatia
OBJECTIVE The objective of this study was to investigate the neurovascular and anatomical differences in patients with lumbosacral transitional vertebrae (LSTV) and the associated risk of neurovascular injury in minimally invasive spine surgery. METHODS The authors performed a retrospective study of CT and MR images of the lumbar spine obtained at their institution between 2010 and 2014. The following characteristics were evaluated: level of the iliac crest in relation to the L4-5 disc space, union level of the iliac veins and arteries in relation to the L4-5 disc space, distribution of the iliac veins and inferior vena cava according to the different Moro zones (A, I, II, III, IV, P) at the L4-5 disc space, and the location of the psoas muscle at the L4-5 disc space...
September 23, 2016: Journal of Neurosurgery. Spine
Kartik G Krishnan, Karsten Schöller, Eberhard Uhl
BACKGROUND: The basic necessities for surgical procedures are illumination, exposure and magnification. These have undergone transformation in par with technology. One of the recent developments is the compact magnifying exoscope system. In this report we describe the application of this system for surgical operations and discuss its advantages and pitfalls. METHODS: We used the ViTOM(®) exoscope mounted on the mechanical holding arm. The following surgical procedures were conducted: lumbar and cervical spinal canal decompression (n=5); laminotomy and removal of lumbar migrated disc herniations (n=4); anterior cervical discectomy and fusion (n=1); removal of intraneural schwannomas (n=2); removal of a acute cerebellar hemorrhage (n=1); removal of a parafalcine atypical cerebral hematoma caused by a dural arterio-venous fistula (n=1); microsutures and anastomoses of a nerve (n=1), an artery (n=1) and veins (n=2)...
September 19, 2016: World Neurosurgery
Dae Chul Suh, Ji Eun Park, Hairi Liu, Sung Chul Jung
OBJECTIVE: To promote embolization of spinal dural arteriovenous fistula (SDAVF) with a small long tortuous feeder that may impede successful application of an embolic agent. METHODS: An induced-wedge technique was developed in which blood flow was blocked by coiling at the proximal part of the microcatheter for secure injection of N-butyl cyanoacrylate. We used this techniques in 11 SDAVF patients (M:F = 8:3): 7 thoracic, 2 lumbar, 1 sacral, and 1 cervical. Clinical outcome was evaluated by the Aminoff-Logue Disability Scale...
September 13, 2016: World Neurosurgery
A Najjar, F Zairi, T Sunna, A Weil, L Estrade, A Weill, D Shedid
BACKGROUND: Vascular lesions of the spinal cord are increasingly recognized. The most common types of these lesions are dural arteriovenous fistulas (AVFs) whereas, extradural AVFs are a very rare type of spinal AVF and can be associated with either extradural or intradural venous reflux. This results in neurological deficits through congestive or compressive myeloradiculopathy. These lesions must be treated to allow stabilization or improvement of neurologic status, either by endovascular therapy or microsurgical interruption...
September 8, 2016: Neuro-Chirurgie
H X Zhang, L Zhao, L L Ma, X F Hou, L Liu, S H Deng
OBJECTIVE: To evaluate the safety and efficacy of retroperitoneal laparoscopic nephrectomy with autotransplantation in cases of severe iatrogenic proximal ureteral damage. METHODS: From July 2011 to March 2015, two patients, aged 44 (female) and 54 years (male), underwent retroperitoneal laparoscopic nephrectomy and autotransplantation for treatment of severe iatrogenic proximal ureteral injuries. Both injuries were proximal ureteral avulsion during ureterolithotomy with the holmium laser for ureteral calculi...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Catherine Hatzantonis, Marcin Czyz, Renata Pyzik, Bronek M Boszczyk
BACKGROUND: Vertebroplasty carries multiple complications due to the leakage of polymethylmethacrylate (PMMA) into the venous system through the iliolumbar or epidural veins. The rate of venous cement complications may vary from 1 to 10 %, with cement extravasation into the venous system in 24 % of patients. Emboli may further migrate into the right heart chambers and pulmonary arteries. Patients may vary in presentation from asymptomatic or symptoms such as syncope to life-threatening complications...
August 17, 2016: European Spine Journal
Seiichiro Shishido, Takeshi Kawamura, Yuko Hamasaki, Yusuke Takahashi, Yoshihiro Itabashi, Masaki Muramatsu, Hiroyuki Satoh, Atsushi Aikawa
BACKGROUND: Children with a compromised inferior vena cava (IVC) were previously considered unsuitable for kidney transplantation because of the technical difficulties and the increased risk of graft thrombosis secondary to inadequate renal venous outflow. METHODS: We conducted a retrospective study of 11 transplants in 9 patients with end-stage renal disease and thrombosed IVCs who received adult kidney allografts between 2000 and 2015. The mean age at transplantation was 7...
June 2016: Transplantation Direct
Sirinad Tankruad, Athikhun Suwannakhan, Chinnawut Suriyonplengsaeng, Krai Meemon
Duplication of the inferior vena cava was detected in a 71-year-old Thai male cadaver with unknown cause of death. Two inferior vena cavae located on each side of the lumbar vertebrae were identified. The right inferior vena cava was formed by fusion of the right and left common iliac veins and had a normal course, while the left inferior vena cava arose from the left branch of the left external iliac vein and ascended parallel to the abdominal aorta. To our knowledge, no similar case has been previously reported...
July 11, 2016: Anatomical Science International
Tyler S Beveridge, Brian L Allman, Marjorie Johnson, Adam Power, Joel Sheinfeld, Nicholas E Power
PURPOSE: Metastatic testis cancer in the retroperitoneum presents a technical challenge to urologists in the primary and post-chemotherapy settings. Where possible, bilateral nerve sparing retroperitoneal lymph node dissection should be performed in an effort to preserve ejaculatory function. However, this is often difficult to achieve, given the complex neurovascular anatomy. To address this we performed what is to our knowledge the first comprehensive examination of the anatomical relationships between the sympathetic nerves of the aortic plexus and the lumbar vessels to facilitate navigation and nerve sparing during bilateral retroperitoneal lymph node dissection...
July 5, 2016: Journal of Urology
Lin Ou-Yang, Guang-Ming Lu
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To explore the underlying anatomy of MTS using CT and discuss its clinical significance for typing diagnosis. SUMMARY OF BACKGROUND DATA: Because the anatomical position of the corpse cannot fully illustrate the actual clinical situation in vivo, the diversity of MTS has not been fully elucidated yet. METHODS: Retrospectively analysed the data of 69 patients with MTS. By CT showing, patients were categorized to simple MTS (sMTS, 22), lumbar degeneration-related MTS (dMTS, 33) and other causes MTS (oMTS, 14); meanwhile, a healthy control group were set...
July 1, 2016: Spine
P-E Moreau, C-H Flouzat-Lachaniette, J Lebhar, G Mirouse, A Poignard, J Allain
PURPOSE: L4-L5 isthmic spondylolisthesis may be associated with lumbosacral transitional vertebrae (LSTV) and altered venous vascular anatomy. The objectives of this study were to describe the anatomical characteristics of L4-L5 ISPL and the intraoperative difficulties encountered during the approach for anterior lumbar interbody fusion (ALIF). METHODS: This is a retrospective review of 20 ALIFs for L4-L5 ISPL. The anatomy of the common iliac veins confluence and the position of L4-L5 with respect to the projection of the iliac crest were analysed on CT-scan...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Tara Horrill
A 65-year-old man presents to the emergency department with increasing back pain. His history includes hypertension, peripheral neuropathy, duodenal ulcer, superior mesenteric vein thrombus, stage IIB colon cancer treated with surgery and adjuvant chemotherapy, renal cell carcinoma treated with surgery, and prostate cancer treated with surgery and radiation. He is otherwise healthy. His family history is positive for colon cancer. Physical examination found significantly elevated blood pressure and a computed tomography scan of the thoracic and lumbar spine was performed, with findings of a type B aortic dissection extending from the aberrant right subclavian artery down to the abdominal aorta...
July 1, 2016: Oncology Nursing Forum
Agnieszka Saracen, Zbigniew Kotwica
Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins-osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area or epidural space. We analyzed results of treatment and complications of vertebroplasty performed with the use of polimethylomethylacrylate cement (PMMA) on 1100 vertebrae, with a special regard to the severity of complication and eventual clinical manifestation...
June 2016: Medicine (Baltimore)
Jingchao Wei, Wenyi Li, Yueying Pei, Yong Shen, Jia Li
BACKGROUND: The purpose of this study aimed to assess preoperative risk factors for the incidence of deep venous thromboembolism in patients undergoing posterior lumbar interbody fusion (PLIF). METHODS: The diagnosis of preoperative deep vein thrombosis (DVT) was confirmed by Doppler ultrasonography. To examine the preoperative risk factors for DVT admitted for PLIF, comparative analysis of the DVT-positive and DVT-negative groups was done. RESULTS: DVT was detected in 9...
2016: Journal of Orthopaedic Surgery and Research
Toshihiko Satake, Reiko Nakasone, Shinji Kobayashi, Jiro Maegawa
The lumbar artery perforator (LAP) flap, which contains excess skin and fat tissue, love handles, that extends from the lower back to upper buttock, may provide an alternate tissue source for autologous breast reconstruction. However, LAP flap use during this procedure frequently requires vessel interposition grafts to correct the short flap pedicle length and mismatched recipient vessel calibre. A 46-year-old patient underwent a right nipple-sparing mastectomy using a lateral approach for ductal carcinoma in situ and immediate LAP flap breast reconstruction...
January 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Carolina Lugo-Fagundo, John W Nance, Pamela T Johnson, Elliot K Fishman
May-Thurner syndrome (MTS) is a venous compression syndrome in which the left common iliac vein is compressed between the lower lumbar spine and the right common iliac artery. While asymptomatic compression is very common, the process can lead to morbidity in selected individuals, most commonly deep venous thrombosis (DVT) and the sequelae thereof. Radiologists must recognize the diagnosis because of the unique management, which differs from DVT without iliac vein compression. The current pictorial essay will review the pathophysiology, imaging, and treatment of MTS...
October 2016: Abdominal Radiology
Daniel M Sciubba, Rafael De la Garza Ramos, C Rory Goodwin, Risheng Xu, Ali Bydon, Timothy F Witham, Ziya L Gokaslan, Jean-Paul Wolinsky
PURPOSE: To report outcomes after total en bloc spondylectomy (TES) for primary aggressive/malignant tumors of the lumbar spine. METHODS: We performed a retrospective review of 23 neurosurgical patients operated between 2004 and 2014. Outcomes included perioperative complication rates and reoperation rates for instrumentation failure. The relationship between patient/operative parameters and complication development/instrumentation failure was investigated. RESULTS: There were 15 men (65...
June 4, 2016: European Spine Journal
Jing Li, Qinghua Mao, Zhanguo Sun, Qingchen Li
During the educational dissection of a 68-year-old Chinese male cadaver, an azygos vein (AV) coursing on the left side with double superior vena cava was observed. The left superior vena cava (LSVC) began from the confluence of the left internal jugular and left subclavian veins, and extended downwards medially into the left edge of the dilated coronary sinus. The right superior vena cava was formed by the union of the right internal jugular and right subclavian veins, and drained into the right atrium from the above...
June 1, 2016: Surgical and Radiologic Anatomy: SRA
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