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https://www.readbyqxmd.com/read/29780061/a-retroaortic-left-renal-vein-in-a-female-cadaver
#1
Yoshiko Fujishima, Koichi Watanabe, Yoko Tabira, Joe Iwanaga, Yui Odo, Tsuyoshi Saga, R Shane Tubbs, Koh-Ichi Yamaki
We encountered a case of retroaortic left renal vein (RLRV) during an anatomical dissection course at our medical school in 2017. The case was a female cadaver who was 88 years old at death. Six roots of the left renal vein (RV) arose from the hilus of the kidney and joined to form one left renal vein, crossed dorsal to the abdominal aorta (AA) at the level of the second lumbar vertebra, and then drained into the inferior vena cava (IVC). Two roots joined at the right renal hilus to become the right RV to then drain into the IVC at the level of the first lumbar vertebral body...
May 21, 2018: Kurume Medical Journal
https://www.readbyqxmd.com/read/29779990/may-thurner-syndrome-in-operative-ankle-fracture-dislocations-a-case-report
#2
Joshua L Moore, Kelly M Pirozzi, Corine Creech, Benjamin Marder
May-Thurner syndrome (MTS) is a rare condition in which patients develop iliofemoral deep venous thrombosis owing to an anatomic variant in which the right common iliac artery overlies and compresses the left common iliac vein against the lumbar spine. Data regarding lower extremity trauma in patients with previously diagnosed MTS are rare. We discuss the operative approach for ankle trauma occurring 3 weeks after endovascular surgery for the treatment of MTS.
May 17, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29772369/sciatic-neuralgia-caused-by-may-thurner-syndrome-case-report
#3
Kazuaki Yamamoto, Gakuji Gondo, Hidemitsu Ogino, Tsuyoshi Watanabe, Masahiko Tanaka, Satoshi Tanaka, Taisuke Kawasaki
BACKGROUND: Sciatic neuralgia (SN) is a type of pain commonly associated with lumbosacral radiculopathy. May-Thurner syndrome (MTS) is a disease characterized by venous congestion in the left common iliac vein (LCIV) due to right common iliac artery compression. In this report, the authors describe a case of MTS with SN as the first presenting symptom. CASE DESCRIPTION: A 53-year-old man gradually developed left SN; however, radiological examination showed no causal findings...
May 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29712527/propensity-matched-comparison-of-outcomes-and-cost-after-macroscopic-and-microscopic-lumbar-discectomy-using-a-national-longitudinal-database
#4
Arjun Vivek Pendharkar, Paymon Garakani Rezaii, Allen Lin Ho, Eric Scott Sussman, David Arnold Purger, Anand Veeravagu, John Kevin Ratliff, Atman Mukesh Desai
OBJECTIVE There has been considerable debate about the utility of the operating microscope in lumbar discectomy and its effect on outcomes and cost. METHODS A commercially available longitudinal database was used to identify patients undergoing discectomy with or without use of a microscope between 2007 and 2015. Propensity matching was performed to normalize differences between demographics and comorbidities in the 2 cohorts. Outcomes, complications, and cost were subsequently analyzed using bivariate analysis...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29707550/complications-on-minimally-invasive-oblique-lumbar-interbody-fusion-at-l2-l5-levels-a-review-of-the-literature-and-surgical-strategies
#5
REVIEW
Javier Quillo-Olvera, Guang-Xun Lin, Hyun-Jin Jo, Jin-Sung Kim
Fusion is the cornerstone in the treatment of an unstable degenerative lumbar spinal disease. Various techniques have been developed. Amongst these techniques exists the oblique lumbar interbody fusion (OLIF), which is the ante-psoas approach. Adequate restoration of disc height with large cages placed in the intervertebral space, indirect decompression, and correction of sagittal and coronal alignment can be achieved with OLIF procedure with the advantage of minimal risk for the psoas muscle and lumbar plexus...
March 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29676670/timing-severity-of-deficits-and-clinical-improvement-after-surgery-for-spinal-dural-arteriovenous-fistulas
#6
Michael M Safaee, Aaron J Clark, Jan-Karl Burkhardt, Ethan A Winkler, Michael T Lawton
OBJECTIVE Spinal dural arteriovenous fistulas (dAVFs) are rare vascular abnormalities caused by arteriovenous shunting. They often form at the dural root sleeve between a radicular feeding artery and draining medullary vein causing venous congestion and edema, decreased perfusion, and ischemia of the spinal cord. Treatment consists of either surgical ligation of the draining vein or selective embolization via an endovascular approach. There is a paucity of data on which modality provides more durable and effective outcomes...
April 20, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29662744/postoperative-complications-associated-with-rhbmp2-use-in-posterior-posterolateral-lumbar-fusion
#7
Nabil Esmail, Zorica Buser, Jeremiah R Cohen, Darrel S Brodke, Hans-Joerg Meisel, Jong-Beom Park, Jim A Youssef, Jeffrey C Wang, S Tim Yoon
Study Design: Retrospective database review. Objective: Posterior/posterolateral lumbar fusion (PLF) is an effective treatment for a variety of spinal disorders; however, variations in surgical technique have different complication profiles. The aim of our study was to quantify the frequency of various complications in patients undergoing PLF with and without human recombinant bone morphogenetic protein 2 (rhBMP2). Methods: We queried the orthopedic subset of the Medicare database (PearlDiver) between 2005 and 2011 for patients undergoing PLF procedures with and without rhBMP2...
April 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29649610/evaluating-the-effect-of-growing-patient-numbers-and-changing-data-elements-in-the-national-surgical-quality-improvement-program-nsqip-database-over-the-years-a-study-of-posterior-lumbar-fusion-outcomes
#8
B N Shultz, P Bovonratwet, N T Ondeck, T D Ottesen, R P McLynn, J N Grauer
BACKGROUND CONTEXT: The use of national databases in spinal surgery outcomes research is increasing. A number of variables collected by the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) changed between 2010 and 2011, coinciding with a rapid increase in the number of patients included per year. However, there has been limited study evaluating the effect that these changes may have on the results of outcomes studies. PURPOSE: To investigate the influence of changing data elements and growth of the NSQIP database on results of lumbar fusion outcomes studies...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29563380/a-pitfall-in-the-diagnosis-of-bilateral-deep-vein-thrombosis-in-a-young-man
#9
Yusuke Adachi, Kenichi Sakakura, Tomohisa Okochi, Takaaki Mase, Mitsunari Matsumoto, Hiroshi Wada, Hideo Fujita, Shin-Ichi Momomura
A 32-year-old man with a history of bronchial asthma was referred for low back pain and bilateral femur pain. Vascular sonography revealed bilateral deep vein thrombosis (DVT) from the femoral veins to the popliteal veins. Computed tomography revealed hypoplasia of the inferior vena cava (IVC) and dilated lumbar veins, ascending lumbar veins, and azygos vein as collaterals. There was no evidence of malignant neoplasm. The results of the thrombophilia tests were within normal limits. Hypoplasia of the IVC is a rare cause of DVT...
March 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29527984/surgical-challenge-in-pediatric-kidney-transplant-vascular-anastomosis
#10
Atsushi Aikawa, Masaki Muramatsu, Yusuke Takahashi, Yuko Hamasaki, Junya Hashimoto, Mai Kubota, Takeshi Kawamura, Yoshihiro Itabashi, Yoiji Hyodou, Seiichiro Shishido
During pediatric kidney transplant, surgical challenges occasionally occur. In particular, vascular anastomosis should be considered for children with small body weight < 12 kg, multiple renal arteries, vascular anomaly, and inferior vena cava occlusion. In pediatric patients, a living-donor renal graft is usually donated from a parent. Therefore, the renal artery and vein are too large to be anastomosed with the recipient's internal iliac artery and external iliac vein. In children who are > 12 kg, the renal artery and vein could be anastomosed with the external iliac artery and the external iliac vein...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29519787/quantitative-phase-contrast-mr-angiography-to-measure-hemodynamic-changes-in-idiopathic-intracranial-hypertension
#11
J Juhász, T Lindner, C Riedel, N G Margraf, O Jansen, A Rohr
BACKGROUND AND PURPOSE: Idiopathic intracranial hypertension is a syndrome of raised intracranial pressure of unknown etiology. Few MR imaging-based studies have investigated arterial and venous blood flow in these patients. Results are inconclusive, and to our knowledge, no comparison of the hemodynamic parameters before and after CSF pressure reduction has been published. The aim of this study was to assess the short-term effects of normalizing CSF pressure on intracranial flow to better understand the pathophysiology of idiopathic intracranial hypertension...
April 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29490591/deep-inferior-epigastric-artery-perforator-flap-harvest-after-full-abdominoplasty
#12
Assaf A Zeltzer, Randy A De Baerdemaeker, Benoit Hendrickx, Katrin Seidenstücker, Carola Brussaard, Moustapha Hamdi
Abdominal scars are no longer a contra-indication for abdominal perforator flap harvesting. Few research data exists about the regeneration potential of the abdominal wall's perforator system. Therefore, previous abdominoplasty with umbilical transposition is an absolute contra-indication for a DIEaP-flap (deep inferior epigastric artery perforator flap). A 50-year-old patient required a breast reconstruction of the right breast, 10 years after an abdominoplasty with undermining of the superior abdomen and umbilical transposition...
March 1, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29399519/may-thurner-diagnosis-and-endovascular-management
#13
REVIEW
M-Grace Knuttinen, Sailendra Naidu, Rahmi Oklu, Scott Kriegshauser, William Eversman, Lisa Rotellini, Patricia E Thorpe
Common left iliac vein compression, otherwise known as May-Thurner (MT), is an anatomical risk factor for lower extremity deep vein thrombosis (DVT). MT refers to chronic compression of the left iliac vein against the lumbar spine by the overlying right common iliac artery. The compression may be asymptomatic. The syndrome is a clinical spectrum of physical findings and history plus the lesion. It is characterized by the varying degrees of venous hypertension. This can be non-thrombotic, combined with acute DVT or post-thrombotic...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29349403/a-novel-hybrid-left-renal-vein-transposition-and-endovascular-stenting-technique-for-the-treatment-of-posterior-nutcracker-syndrome
#14
Kristin Stawiarski, Matthew Wosnitzer, Young Erben
Posterior nutcracker syndrome occurs when a retroaortic left renal vein becomes compressed between the abdominal aorta and the lumbar spine. Although open surgical approaches remain the treatment of choice, endovascular stenting has been used successfully. We describe a case of a 28-year-old man who presented with microscopic hematuria, left-sided flank pain, and testicular swelling. Computed tomography findings were consistent with posterior nutcracker syndrome. He underwent a novel hybrid operation that included left renal vein transposition followed by endovascular stenting...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29306251/evaluation-of-renal-anomalies-inferior-vena-cava-variations-and-left-renalvein-variations-by-lumbar-magnetic-resonance-imaging-in-3000-patients
#15
Alper Dilli, Fatma Sevin Coşar Ayaz, Keziban Karacan, Kürşad Zengin, Ümit Yaşar Ayaz, Osman Raif Karabacak, Baki Hekimoğlu
Background/aim: The variations and anomalies of the kidneys besides the variations of the inferior vena cava (IVC) and left renal vein (LRV) are mostly asymptomatic, but they carry potential risks particularly during retroperitoneal surgery and radiological interventions. Our aim was to find the frequencies, types, and sex distribution of renal anomalies and variations of the IVC and LRV utilizing magnetic resonance imaging (MRI). Materials and methods: Between November 2010 and April 2011, a retrospective study was conducted including lumbar spinal MRI of 3000 consecutive patients (1869 females and 1131 males) with a median age of 54 years (range: 9-78 years)...
December 19, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29287820/health-related-quality-of-life-scores-underestimate-the-impact-of-major-complications-in-lumbar-degenerative-scoliosis-surgery
#16
Steven D Glassman, Keith H Bridwell, Christopher I Shaffrey, Charles C Edwards, Jon D Lurie, Christine R Baldus, Leah Y Carreon
STUDY DESIGN: Retrospective cohort. OBJECTIVE: To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. SUMMARY OF BACKGROUND DATA: HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. METHODS: We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59...
January 2018: Spine Deformity
https://www.readbyqxmd.com/read/29284846/comparison-of-the-intravenous-and-epidural-administration-of-tumor-necrosis-factor-alpha-antagonists-in-an-experimental-rat-pain-model
#17
Serbülent Gökhan Beyaz, Mustafa Erkan İnanmaz, Tolga Ergönenç, Onur Palabıyık, Yakup Tomak, Ayça Taş Tuna
Introduction: Inflammatory cytokines secreted from the nucleus pulposus are thought to lead to lumbar nerve root compression-like symptoms. Tumor necrosis factor-alpha (TNF-α), an inflammatory cytokine, likely plays an important role in lumbar disc hernia-related leg pain. In this experimental study, we compared the effectiveness of TNF-α antagonists administered through the intravenous or epidural route in lumbar spine pathologies. Materials and Methods: After ethics committee approval had been obtained, 24 Sprague Dawley male rats aged 70-90 days and weighing 250-300 g each were allocated to four groups...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284601/clinical-and-radiologic-characteristics-of-deep-lumbosacral-dural-arteriovenous-fistulas
#18
F Jablawi, O Nikoubashman, G A Schubert, M Dafotakis, F-J Hans, M Mull
BACKGROUND AND PURPOSE: Spinal dural arteriovenous fistulas located in the deep lumbosacral region are rare and the most difficult to diagnose among spinal dural arteriovenous fistulas located elsewhere in the spinal dura. Specific clinical and radiologic features of these fistulas are still inadequately reported and are the subject of this study. MATERIALS AND METHODS: We retrospectively evaluated all data of patients with spinal dural arteriovenous fistulas treated and/or diagnosed in our institution between 1990 and 2017...
February 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29248773/spine-surgery-complicated-by-an-engorged-lumbar-epidural-venous-plexus-from-cerebrospinal-fluid-overshunting-a-case-report-and-review-of-the-literature
#19
Vance L Fredrickson, Arati Patel, Martin H Pham, Ben A Strickland, Ifije Ohiorhenuan, Thomas Chen
BACKGROUND: Overshunting of cerebrospinal fluid may lead to intracranial hypotension and dilation of spinal epidural veins. Radiculopathy may rarely occur secondary to engorged spinal epidural veins. In addition, the cause of radiculopathy may be obscured by concomitant spinal degenerative changes. We present a case and review the pathogenesis as well as the current clinical literature. CASE DESCRIPTION: A 29-year-old woman presented with positional headaches from intracranial hypotension in the setting of cerebrospinal fluid overshunting...
March 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29159805/the-anatomy-of-the-infrarenal-lumbar-splanchnic-nerves-in-human-cadavers-implications-for-retroperitoneal-nerve-sparing-surgery
#20
Tyler S Beveridge, Dale E Fournier, Adam M R Groh, Marjorie Johnson, Nicholas E Power, Brian L Allman
Injury to the nerves of the aortic- and superior hypogastric plexuses during retroperitoneal surgery often results in significant post-operative complications, including retrograde ejaculation and/or loss of seminal emission in males. Although previous characterizations of these plexuses have done well to provide a basis for understanding the typical anatomy, additional research into the common variations of these plexuses could further optimize nerve-sparing techniques for retroperitoneal surgery. To achieve this, the present study aimed to document the prevalence and positional variability of the infrarenal lumbar splanchnic nerves (LSNs) through gross dissection of 26 human cadavers...
January 2018: Journal of Anatomy
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