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Peripheral nerve surgery

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https://www.readbyqxmd.com/read/29216474/magnetic-resonance-neurography-of-traumatic-and-nontraumatic-peripheral-trigeminal-neuropathies
#1
John R Zuniga, Cyrus Mistry, Igor Tikhonov, Riham Dessouky, Avneesh Chhabra
PURPOSE: The clinical neurosensory testing (NST) is currently the reference standard for the diagnosis of traumatic and nontraumatic peripheral trigeminal neuropathies (PTNs) but exhibits both false-positive and false-negative results compared with surgical findings and frequently results in treatment decision delays. We tested the hypothesis that magnetic resonance neurography (MRN) of PTNs can serve as a diagnostic modality by correlating the NST, MRN, and surgical findings. MATERIALS AND METHODS: Sixty patients with traumatic and nontraumatic PTN of varying etiologies and Sunderland classifications underwent NST, followed by MRN using 1...
November 16, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29200998/attenuation-of-the-infiltration-of-angiotensin-ii-expressing-cd3-t-cells-and-the-modulation-of-nerve-growth-factor-in-lumbar-dorsal-root-ganglia-a-possible-mechanism-underpinning-analgesia-produced-by-ema300-an-angiotensin-ii-type-2-at2-receptor-antagonist
#2
Nemat Khan, Arjun Muralidharan, Maree T Smith
Recent preclinical and proof-of-concept clinical studies have shown promising analgesic efficacy of selective small molecule angiotensin II type 2 (AT2) receptor antagonists in the alleviation of peripheral neuropathic pain. However, their cellular and molecular mechanism of action requires further investigation. To address this issue, groups of adult male Sprague-Dawley rats with fully developed unilateral hindpaw hypersensitivity, following chronic constriction injury (CCI) of the sciatic nerve, received a single intraperitoneal bolus dose of the small molecule AT2 receptor antagonist, EMA300 (10 mg kg-1), or vehicle...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/29196938/the-hemodynamic-and-pain-impact-of-peripheral-nerve-block-versus-spinal-anesthesia-in-diabetic-patients-undergoing-diabetic-foot-surgery
#3
Hou Yee Lai, Li Lian Foo, Siu Min Lim, Chen Fei Yong, Pui San Loh, Sook Hui Chaw, Mohd Shahnaz Hasan, Chew Yin Wang
PURPOSE: Comparison of hemodynamic profiles and pain scores in diabetic patients undergoing diabetic foot surgery receiving peripheral nerve block (PNB) or spinal anesthesia [subarachnoid block (SAB)]. METHODS: This was a prospective, randomised controlled trial. We recruited diabetic patients aged > 18 years, American Society of Anesthesiologists class II-III, who were scheduled for unilateral diabetic foot surgery below the knee. All patients were assessed for autonomic dysfunction using the Survey of Autonomic Symptoms score...
December 1, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29192065/peripheral-nerve-function-estimation-by-linear-model-of-multi-cmap-responses-for-surgical-intervention-in-acoustic-neuroma-surgery
#4
Dilok Puanhvuan, Sorayouth Chumnanvej, Yodchanan Wongsawat
Nerve function assessments are crucial for surgical intervention during acoustic neuroma surgery. Cranial nerves such as acoustic and facial nerves, can be possibly damaged during tumor dissection. Proper surgical intervention should prevent neurological deficit and achieve total tumor removal. Conventionally, nerve function is qualitatively evaluated by surgeon and neurologist. Facial nerves can be preserved by monitoring the compound muscle action potential (CMAP) response. The differences in the amplitude and latency of CMAP are used as indicators during surgical interventions...
December 2017: Physiological Reports
https://www.readbyqxmd.com/read/29190116/alarmins-in-frozen-shoulder-a-molecular-association-between-inflammation-and-pain
#5
Jonathon Z B Cher, Moeed Akbar, Susan Kitson, Lindsay A N Crowe, Emma Garcia-Melchor, Stephen C Hannah, Michael McLean, Umberto G Fazzi, Shauna C Kerr, George A C Murrell, Neal L Millar
BACKGROUND: The pathophysiological mechanisms behind proliferation of fibroblasts and deposition of dense collagen matrix in idiopathic frozen shoulder remain unclear. Alarmins (also known as danger signals) are endogenous molecules that are released into the extracellular milieu after infection or tissue injury and that signal cell and tissue damage. PURPOSE: To investigate whether the presence of alarmins is higher in patients with idiopathic frozen shoulder than in control subjects...
November 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29189439/leading-causes-of-anesthesia-related-liability-claims-in-ambulatory-surgery-centers
#6
Darrell Ranum, Anair Beverly, Fred E Shapiro, Richard D Urman
OBJECTIVE: We present a contemporary analysis of patient injury, allegations, and contributing factors of anesthesia-related closed claims, which involved cases that specifically occurred in free-standing ambulatory surgery centers (ASCs). METHODS: We examined ASC-closed claims data between 2007 and 2014 from The Doctors Company, a medical malpractice insurer. Findings were coded using the Comprehensive Risk Intelligence Tool developed by CRICO Strategies. We compared coded data from ASC claims with hospital operating room (HOR) claims, in terms of injury severity category, nature of injury, nature of allegation, contributing factors identified, and contributing comorbidities and claim value...
November 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29183522/peripheral-nerve-injury-during-abdominal-pelvic-surgery-analysis-of-the-national-surgical-quality-improvement-program-database
#7
Christopher J D Wallis, Sarah Peltz, James Byrne, Jamie Kroft, Paul Karanicolas, Natalie Coburn, Avery B Nathens, Robert K Nam, Julie Hallet, Raj Satkunasivam
Peripheral nerve injury (PNI) is a rare but preventable complication of surgery. We sought to assess whether the use of minimally invasive surgery (MIS) affects the occurrence of PNI. Using the American College of Surgeons National Surgical Quality Improvement Program database, we examined rates of PNI among patients undergoing appendectomy, hysterectomy, colectomy, or radical prostatectomy between 2005 and 2012. We assessed the effect of MIS, as compared with open surgery, on PNI occurrence using logistic regression...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29182019/pain-and-function-following-revision-cubital-tunnel-surgery
#8
Kristen M Davidge, Gregory C Ebersole, Susan E Mackinnon
BACKGROUND: The purpose of this study was to determine pain and functional outcomes following revision cubital tunnel surgery and to identify predictors of poor postoperative outcome. METHODS: A retrospective cohort study was conducted of all patients undergoing revision cubital tunnel surgery over a 5-year period at a high-volume peripheral nerve center. Intraoperative findings, demographic and injury factors, and outcomes were reviewed. Average pain, worst pain, and impact of pain on self-perceived quality of life were each measured using a 10-cm visual analog scale (VAS)...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29179472/bcrp-expression-in-schwannoma-plexiform-neurofibroma-and-mpnst
#9
Maurits de Vries, Olaf van Tellingen, Andel G L van der Mey, Antonius M G Bunt, Inge Briaire-de Bruijn, Pancras C W Hogendoorn
Background: peripheral nerve sheath tumors comprise a broad spectrum of neoplasms. Vestibular schwannomas and plexiform neurofibromas are symptomatic albeit benign, but a subset of the latter pre-malignant lesions will transform to malignant peripheral nerve sheath tumors (MPNST). Surgery and radiotherapy are the primary strategies to treat these tumors. Intrinsic resistance to drug therapy characterizes all three tumor subtypes. The breast cancer resistance protein BCRP is a transmembrane efflux transporter considered to play a key role in various biological barriers such as the blood brain barrier...
October 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/29178500/identifying-unique-subtypes-of-spinal-afferent-nerve-endings-within-the-urinary-bladder-of-mice
#10
Nick J Spencer, Sarah Greenheigh, Melinda Kyloh, Tim J Hibberd, Harman Sharma, Luke Grundy, Stuart M Brierley, Andrea M Harrington, Elizabeth A Beckett, Simon J Brookes, Vladimir P Zagorodnyuk
Spinal afferent neurons are responsible for the transduction and transmission of noxious (painful) stimuli and innocuous stimuli that do not reach conscious sensations from visceral organs to the central nervous system. Although the location of the nerve cell bodies of spinal afferents is well known to reside in dorsal root ganglia (DRG), the morphology and location of peripheral nerve endings of spinal afferents that transduce sensory stimuli into action potentials is poorly understood. The individual nerve endings of spinal afferents that innervate the urinary bladder have never been unequivocally identified in any species...
November 27, 2017: Journal of Comparative Neurology
https://www.readbyqxmd.com/read/29177169/local-administration-of-methylprednisolone-laden-hydrogel-enhances-functional-recovery-of-transected-sciatic-nerve-in-rat
#11
Ali Mehrshad, Mohammad Shahraki, Shahin Ehteshamfar
Objective: To determine the effects of methylprednisolone-laden hydrogel loaded into a chitosan conduit on the functional recovery of peripheral nerve using a rat sciatic nerve regeneration model was assessed. Methods: 10-mm sciatic nerve defect was bridged using a chitosan conduit (CHIT/CGP-Hydrogel) filled with CGP-hydrogel. In authograft group (AUTO) a segment of sciatic nerve was transected and reimplanted reversely. In methylprednisolone treated group (CHIT/MP) the conduit was filled with methylprednisolone-laden CGP-hydrogel...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29175571/hypoglossal-schwannoma-of-the-neck-a-case-report-and-review-of-the-literature
#12
Aaron Plitt, Tarek Y El Ahmadieh, Shivani Bindal, Larry Myers, Jonathan White, Wayne Gluf
BACKGROUND: Schwannomas are benign, slow growing neoplasms of the myelin-producing Schwann cells of peripheral nervous system that most commonly affect sensory nerves. Hypoglossal schwannomas, a tumor of a purely motor nerve, comprise less than 5% of all head and neck schwannomas. Since the first description of a hypoglossal schwannoma in 1933, there have been very few case reports of extracranial origins. The most common location of an extracranial hypoglossal schwannoma is in the parapharyngeal space, and can mimic paragangliomas...
November 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29174755/cerebral-plasticity-after-contralateral-cervical-nerve-transfer-in-human-by-longitudinal-pet-evaluation
#13
Hao Ma, Mouxiong Zheng, Yechen Lu, Xuyun Hua, Wendong Xu
OBJECT: The treatment of brachial plexus avulsion injury remains a challenging problem. Admittedly, central nervous mechanisms play a significant role in the motor recovery of the paralyzed hand after peripheral nerve surgery. The present study aimed at investigating the relationship between cerebral reorganization and motor recovery after a unique peripheral crossing nerve transfer surgery in brachial plexus injury patients. METHODS: In the present study, two brachial plexus avulsion injury patients with were followed up for 4 years after contralateral C7 nerve transfer surgery...
November 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29173429/intraoperative-neurophysiologic-monitoring-for-degenerative-cervical-myelopathy
#14
REVIEW
Masaaki Takeda, Satoshi Yamaguchi, Takafumi Mitsuhara, Masaru Abiko, Kaoru Kurisu
Multimodal intraoperative neurophysiologic monitoring is a reliable tool for detecting intraoperative spine injury and is recommended during surgery for degenerative cervical myopathy (DCM). Somatosensory evoked potential (SEP) can be used to monitor spine and peripheral nerve injury during positioning in surgery for DCM. Compensation technique for transcranial evoked muscle action potentials (tcMEPs) should be adopted in intraoperative monitoring during surgery for DCM. Free-running electromyography is a useful real-time monitoring add-on modality in addition to SEP and tcMEP...
January 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29171437/mir-30c-promotes-schwann-cell-remyelination-following-peripheral-nerve-injury
#15
Sheng Yi, Qi-Hui Wang, Li-Li Zhao, Jing Qin, Ya-Xian Wang, Bin Yu, Song-Lin Zhou
Differential expression of miRNAs occurs in injured proximal nerve stumps and includes miRNAs that are firstly down-regulated and then gradually up-regulated following nerve injury. These miRNAs might be related to a Schwann cell phenotypic switch. miR-30c, as a member of this group, was further investigated in the current study. Sprague-Dawley rats underwent sciatic nerve transection and proximal nerve stumps were collected at 1, 4, 7, 14, 21, and 28 days post injury for analysis. Following sciatic nerve injury, miR-30c was down-regulated, reaching a minimum on day 4, and was then upregulated to normal levels...
October 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29166664/is-there-a-reasonable-excuse-for-not-providing-post-operative-analgesia-when-using-animal-models-of-peripheral-neuropathic-pain-for-research-purposes
#16
Sara Hestehave, Gordon Munro, Rie Christensen, Tina Brønnum Pedersen, Lars Arvastson, Philip Hougaard, Klas S P Abelson
INTRODUCTION: The induction of neuropathic pain-like behaviors in rodents often requires surgical intervention. This engages acute nociceptive signaling events that contribute to pain and stress post-operatively that from a welfare perspective demands peri-operative analgesic treatment. However, a large number of researchers avoid providing such care based largely on anecdotal opinions that it might interfere with model pathophysiology in the longer term. OBJECTIVES: To investigate effects of various peri-operative analgesic regimens encapsulating different mechanisms and duration of action, on the development of post-operative stress/welfare and pain-like behaviors in the Spared Nerve Injury (SNI)-model of neuropathic pain...
2017: PloS One
https://www.readbyqxmd.com/read/29160568/nerve-detection-using-optical-spectroscopy-an-evaluation-in-four-different-models-in-human-and-swine-in-vivo-and-post-mortem
#17
Gerrit C Langhout, Torre M Bydlon, Marjolein van der Voort, Manfred Müller, Jeroen Kortsmit, Gerald Lucassen, Andrea J R Balthasar, Geert-Jan van Geffen, Thorsten Steinfeldt, Henricus J C M Sterenborg, Benno H W Hendriks, Theo J M Ruers
OBJECTIVE: Identification of peripheral nerve tissue is crucial in both surgery and regional anesthesia. Recently, optical tissue identification methods are presented to facilitate nerve identification in transcutaneous procedures and surgery. Optimization and validation of such techniques require large datasets. The use of alternative models to human in vivo, like human post mortem, or swine may be suitable to test, optimize and validate new optical techniques. However, differences in tissue characteristics and thus optical properties, like oxygen saturation and tissue perfusion are to be expected...
November 21, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/29160101/postoperative-analgesia-using-peripheral-anesthetic-block-of-the-foot-and-ankle
#18
Kelly Cristina Stéfani, Gabriel Ferraz Ferreira, Miguel Viana Pereira Filho
BACKGROUND: Anesthetic block of the peripheral nerves in the foot and ankle is generally used as anesthesia. The increased use of anesthetic blocks has made this technique an increasingly safe method, and its use has been expanded to postoperative analgesia in foot and ankle surgeries. The objective of this study was to evaluate the analgesia time and pain intensity, using objective scores, after peripheral nerve block in foot and ankle surgeries. METHODS: Patients who underwent surgery by the foot and ankle group of our institution from March 2016 to January 2017 were invited to participate in this prospective, randomized, and blinded study after signing an informed consent form...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29157770/the-prevention-and-recognition-of-ulnar-nerve-and-brachial-plexus-injuries
#19
Barbara J Duffy, Tito D Tubog
Perioperative peripheral nerve injury is a serious yet preventable perioperative complication. Since the inception of the American Association of Anesthesiologists Closed Claim Project, the incidence of peripheral nerve injury has remained constant with an overall reported prevalence rate of 15% to 16%. To date, the most frequent nerve injuries are ulnar nerve neuropathy and brachial plexus injury. This article will review the clinical presentation, pathophysiology, causative and risks factors, and preventive measures for the two most common nerve injuries...
December 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29150945/development-of-an-in-vivo-mouse-model-of-discogenic-low-back-pain
#20
Changgui Shi, Vaskar Das, Xin Li, Ranjan Kc, Sujun Qiu, InSug O-Sullivan, Richard L Ripper, Jeffrey S Kroin, Fackson Mwale, Atiyayein A Wallace, Bingqian Zhu, Lan Zhao, Andre J van Wijnen, Mingliang Ji, Jun Lu, Gina Votta-Velis, Wen Yuan, Hee-Jeong Im
Discogenic Low back pain (DLBP) is extremely common and costly. Effective treatments are lacking due to DLBP's unknown pathogenesis. Currently, there are no in vivo mouse models of DLBP, which restricts research in this field. The aim of this study was to establish a reliable DLBP model in mouse that captures the pathological changes in the disc and allows longitudinal pain testing. The model was generated by puncturing the mouse lumbar discs (L4/5, L5/6, and L6/S1) and removing the nucleus pulposus using a microscalpel under the microscope...
November 18, 2017: Journal of Cellular Physiology
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