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John Souter, Kevin Swong, Matthew McCoyd, Neelam Balasubramanian, Magan Nielsen, Vikram C Prabhu
BACKGROUND: Common peroneal nerve (CPN) compressive neuropathy is the most common lower-extremity entrapment neuropathy. MATERIALS AND METHODS: A retrospective review of a prospectively maintained single-institution database of all patients with CPN palsy who underwent decompression and neuroplasty over a 5-year period was performed. RESULTS: Thirty patients underwent a neuroplasty of the CPN over a 5-year period (2010-2015) at our institution...
April 2018: World Neurosurgery
Gabor Racz, Kenneth Candido, Standiford Helm
No abstract text is available yet for this article.
January 2018: Anesthesia and Analgesia
Dean Wang, Ryan M Degen, Christopher L Camp, Michael H McGraw, David W Altchek, Joshua S Dines
BACKGROUND: Much controversy exists regarding the optimal surgical intervention for lateral epicondylitis because of a multitude of options available and the lack of comparative studies. Knowledge of the current practice trends would help guide the design of comparative studies needed to determine which surgical technique results in the best outcome. PURPOSE: To review the latest practice trends for the surgical treatment of lateral epicondylitis among newly trained surgeons in the United States utilizing the American Board of Orthopaedic Surgery (ABOS) database...
October 2017: Orthopaedic Journal of Sports Medicine
Hüseyin Toman, Uğur Özdemir, Hasan Ali Kiraz, Nurettin Lüleci
Pneumocephalus is defined as air in the cranial cavity. Pneumocephalus can result from inadvertent dural puncture during lumbar epidural anesthesia or epidural steroid injection. Presently described is case of 41-year-old woman who had undergone lumbar disc hernia operation but due to ongoing complaints, was diagnosed as having failed back surgery syndrome. Percutaneous epidural neuroplasty was performed. In the operating room, under sterile conditions and under sedoanalgesia, Racz catheter was inserted in caudal area and guided to epidural area with scope...
July 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Chang Hyun Oh, Gyu Yeul Ji, Dong Ah Shin, Pyung Goo Cho, Seung Hwan Yoon
BACKGROUND: Cervical disc disease is a common and occasionally disabling condition, occurring as a natural consequence of aging in the vast majority of the adult population. Percutaneous epidural neuroplasty (PEN) has been used to deliver highly concentrated drugs for chronic neck pain and to prevent scarring in cases refractory to conventional epidural blocks. However, the clinical course after PEN in cervical disc disease is not well-documented. OBJECTIVE: The purpose of this study was to evaluate the efficacy of cervical PEN for single-level cervical disc disease...
September 2017: Pain Physician
Hyeong-Jin Lee, Jin-Sung Kim, Kyeong-Sik Ryu
OBJECTIVE: Percutaneous endoscopic lumbar diskectomy and percutaneous epidural neuroplasty is a commonly used minimally invasive spinal surgery in lumbar disk herniation. But to our knowledge, there is no report about the results of percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty. We did this study to evaluate the effect of percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty in lumbar disk herniation. METHODS: We report a series of cases about techniques and results of percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty in lumbar disk herniation, as well as introduce technical procedures and advantages...
February 2017: World Neurosurgery
Tae Hyun Kim, Jun Jae Shin, Woo Yong Lee
BACKGROUND: Percutaneous epidural neuroplasty with a Racz catheter is widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. The breakage or shearing of an epidural catheter, particularly a percutaneous epidural neuroplasty catheter, is reported as a rare complication. There has been a controversy over whether surgical removal of a shorn epidural catheter is needed. Until now, only three cases related to sheared Racz neuroplasty catheters have been reported...
October 6, 2016: Journal of Medical Case Reports
Yun-Joung Han, Myoung No Lee, Min Ji Cho, Hue Jung Park, Dong Eon Moon, Young Hoon Kim
BACKGROUND: Epidural neuroplasty using a Racz catheter has a therapeutic effect. Studies have found no correlation between foraminal stenosis and the outcome of epidural neuroplasty, which is thought to depend on contrast runoff. OBJECTIVE: To examine the correlation between the contrast spread pattern and pain reduction in cervical epidural neuroplasty using a Racz catheter. STUDY DESIGN: Retrospective study. SETTING: An interventional pain-management practice in a university hospital...
September 2016: Pain Physician
Martina Bellini, Massimo Barbieri
Low back and leg pain may be due to many causes, one of which is scarring in the epidural space. Epidural scarring may provoke this pain for many reasons: nerves may be trapped by scars, while veins in the epidural space press down upon the nerves and become enlarged, putting pressure on the nerves. Endoscopic and percutaneous epidural adhesiolysis allows one to eliminate the deleterious effects of scar formation, which can both physically prevent the direct application of drugs to nerve and provide relief in patients who have not responded to epidurals, physical therapy or medication...
2016: Anaesthesiology Intensive Therapy
Ziv M Peled
The targets for the surgical treatment of temporal headaches are the zygomaticotemporal branch of the trigeminal nerve and the auriculotemporal nerve. The former is often accessed by means of an endoscopic brow approach or potentially by laterally extending a transpalpebral incision. An established surgical approach, the Gillies incision, was modified to access the zygomaticotemporal nerve, as it was felt to combine the advantages of the traditional techniques. Nineteen patients underwent zygomaticotemporal nerve decompression and neuroplasty or neurectomy and muscle implantation using this surgical approach...
May 2016: Plastic and Reconstructive Surgery
Guy Yeul Ji, Chang Hyun Oh, Keun Su Won, In Bo Han, Yoon Ha, Dong Ah Shin, Keung Nyun Kim
BACKGROUND: The efficacy of lumbar percutaneous epidural neuroplasty (PEN) as a minimally invasive technique has been relatively well investigated, but the clinical effectiveness of cervical PEN (C-PEN) has yet to be established. OBJECTIVE: The purpose of this study was to compare clinical outcomes between C-PEN and cervical epidural steroid injection (C-ESI). STUDY DESIGN: Randomized control study. SETTING: University hospital center...
February 2016: Pain Physician
Edward P Miranda
OBJECTIVE: A significant subset of patients with migraine headaches has pain relief after neuroplasty/muscular decompression of select cranial and cervical nerves. In the majority of cases, compression occurs secondary to compression of the nerves by adjacent muscles. Previous studies have shown that both surgical decompression and chemical denervation (eg, botulinum toxin) provide relief of migraine headaches; however, controversy remains. If some migraine headaches are caused by muscular compression, then paresis of the compressing muscles by underlying myopathic/metabolic disease should result in migraine relief in some patients...
2015: Eplasty
Chan-Hee Lee, Jang-Won Son, Ung Kim
Stress induced cardiomyopathy (SIC) is becoming increasingly described as an underdiagnosed complication during common medical procedures. Reverse Takotsubo cardiomyopathy (RTC) is a variant of SIC that involves the basal and mid-ventricular segments and spares the apical segments. The authors present a rare case of RTC, following an inadvertent intrathecal injection during percutaneous epidural neuroplasty. Although the precise mechanism involved remains unclear, the direct neurohumoral effects of the hyperbaric anaesthetics and adhesiolytics appear to have resulted in a catecholamine surge and myocardial stunning that precipitated the SIC...
September 2015: Heart, Lung & Circulation
Hyun Yeong Lee, Hui Sun Wang, Seok Won Kim, Chang Il Ju
Epidural neuroplasty is found to be effective in removing fibrous tissue occurring in the epidural space for various reasons. We report a case of cerebellar infarction caused by epidural abscess after epidural neuroplasty. To the best of our knowledge, this is the first report of cerebellar infarction developed as a result of epidural abscess accompanying bacterial meningitis after epidural neuroplasty. We also discuss the etiology, pathogenesis, and prognosis of this rare pathologic entity.
March 2015: Korean Journal of Spine
Yong Seok Lim, Ki Tea Jung, Cheon Hee Park, Sang Woo Wee, Sung Sik Sin, Joon Kim
Recently, percutaneous epidural neuroplasty has become widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. A 19-year-old female patient suffering from left radicular pain caused by an L4-L5 intervertebral disc herniation underwent percutaneous epidural neuroplasty of the left L5 nerve root using a Racz catheter. After the procedure, the patient complained of acute motor weakness in the right lower leg, on the opposite site to where the neuroplasty was conducted...
April 2015: Korean Journal of Pain
Jae Hyuk Kang, Hoon Choi, Jin Sung Kim, Min Kyu Lee, Hue Jung Park
Percutaneous epidural neuroplasty may lead to complications such as hematoma, infection, epidural abscess, meningitis, hypotension, respiratory depression, urinary and fecal dysfunction, sexual dysfunction and paresthesia. Other technical complications may include shearing or tearing, misplacement, blockage and migration of the catheter. We report a case of a 41-year-old female patient, who underwent surgical removal of a sheared catheter, which was retained for 30 months after cervical Racz neuroplasty.
April 2015: Korean Journal of Anesthesiology
Gyu Yeul Ji, Chang Hyun Oh, Bongju Moon, Seung Hyun Choi, Dong Ah Shin, Young Sul Yoon, Keung Nyun Kim
PURPOSE: Percutaneous epidural neuroplasty (PEN) is a minimally invasive treatment. The efficacy of PEN has been relatively well investigated; however, the relationship between the clinical effectiveness of PEN and the severity of spinal canal stenosis by disc material has not yet been established. The purpose of this study was to compare clinical outcomes of PEN according to the dural sac cross-sectional area in single level disc disease. MATERIALS AND METHODS: This study included 363 patients with back pain from single level disc disease with and without radiculopathy...
May 2015: Yonsei Medical Journal
Dong Eon Moon, Hae Jung Park, Young Hoon Kim
BACKGROUND: Epidural neuroplasty using the Racz catheter has a therapeutic effect in patients with cervical disc herniation and central stenosis who do not respond to fluoroscopically guided epidural injections. OBJECTIVE: To evaluate the clinical outcomes of cervical epidural neuroplasty in patients with posterior neck and upper extremity pain and to demonstrate correlations between predictive factors and unsuccessful results of cervical epidural neuroplasty. STUDY DESIGN: Observational study...
March 2015: Pain Physician
Bo Povlsen, Thomas Hansson, Sebastian D Povlsen
BACKGROUND: Thoracic outlet syndrome (TOS) is one of the most controversial diagnoses in clinical medicine. Despite many reports of operative and non-operative interventions, rigorous scientific investigation of this syndrome leading to evidence-based management is lacking. This is the first update of a review first published in 2010. OBJECTIVES: To evaluate the beneficial and adverse effects of the available operative and non-operative interventions for the treatment of TOS a minimum of six months after the intervention...
November 26, 2014: Cochrane Database of Systematic Reviews
Chang Hyun Oh, Guy Yeul Ji, Pyung Goo Cho, Won-Seok Choi, Dong Ah Shin, Keung Nyun Kim, Hyun-Ah Kang
BACKGROUND: Percutaneous epidural neuroplasty (PEN) is a minimally invasive intervention designed to treat neck, back, and low back pain. The efficacy of lumbar PEN has been relatively well investigated, but clinical effectiveness according to catheter position has not yet been established. OBJECTIVE: The purpose of this study was to compare clinical outcomes between the ventral and dorsal positions of the catheter tip during lumbar PEN procedures using a retrospective review series...
September 2014: Pain Physician
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