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lumbosacral plexus

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https://www.readbyqxmd.com/read/28768846/clinical-phenotype-and-outcome-of-hepatitis-e-virus-associated-neuralgic-amyotrophy
#1
Jeroen J J van Eijk, Harry R Dalton, Paolo Ripellino, Richard G Madden, Catherine Jones, Miriam Fritz, Claudio Gobbi, Giorgia Melli, Emanuela Pasi, Jenny Herrod, Rebecca F Lissmann, Hamad H Ashraf, Mohamed Abdelrahim, Omar A B A L Masri, Montserrat Fraga, David Benninger, Thierry Kuntzer, Vincent Aubert, Roland Sahli, Darius Moradpour, Hélène Blasco-Perrin, Shahram Attarian, Rene Gérolami, Philippe Colson, Maria T Giordani, Johannes Hartl, Sven Pischke, Nan X Lin, Brendan N Mclean, Richard P Bendall, Marcus Panning, Jean-Marie Peron, Nassim Kamar, Jacques Izopet, Bart C Jacobs, Nens van Alfen, Baziel G M van Engelen
OBJECTIVE: To determine the clinical phenotype and outcome in hepatitis E virus-associated neuralgic amyotrophy (HEV-NA). METHODS: Cases of NA were identified in 11 centers from 7 European countries, with retrospective analysis of demographics, clinical/laboratory findings, and treatment and outcome. Cases of HEV-NA were compared with NA cases without evidence of HEV infection. RESULTS: Fifty-seven cases of HEV-NA and 61 NA cases without HEV were studied...
August 2, 2017: Neurology
https://www.readbyqxmd.com/read/28756539/intraspinal-intradural-variations-of-nerve-roots
#2
Viktor Matejčík, Zora Haviarová, Andrej Šteňo, Roman Kuruc, Juraj Šteňo
PURPOSE: The aim of this work is to point out the intraspinal anatomical variations of nerve roots and their possible participation in radiculopathy. METHODS: The anatomical study was performed in 33 cadavers. There were 25 male cadavers aged 30-75 years and 8 female cadavers aged 45-77 years, with a mean age of 46.5 years to 24 h from death. All intradural rami communicantes between nerve roots were excised and examined histologically for the presence or absence of nervous tissue...
July 29, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28678646/pain-areas-and-mechanosensitivity-in-patients-with-chronic-pelvic-pain-syndrome-a-controlled-clinical-investigation
#3
Jörgen Quaghebeur, Jean-Jacques Wyndaele, Stefan De Wachter
OBJECTIVE: A thorough clinical assessment including physical examination is crucial in a diagnostic work-up, including in patients with chronic pelvic pain syndrome (CPPS). This study investigated the prevalence of pain areas and the mechanosensitivity of peripheral nerves in patients with CPPS and compared the findings with a healthy control group. MATERIALS AND METHODS: Healthy volunteers and patients diagnosed with CPPS were assessed with physical examinations and neurodynamic testing...
July 5, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28676358/anatomy-and-physiology-of-the-pelvic-floor
#4
REVIEW
Sarah M Eickmeyer
Understanding the anatomic relationship of the pelvic floor muscles with the pelvic girdle, spine, and hips aids the rehabilitation provider in diagnosis, management, and appropriate referrals. The bony anatomy of the pelvic girdle consists of 3 bones and 3 joints. The pelvic floor muscles are comprised mainly of the levator ani muscles with somatic innervation from the lumbosacral plexus. The bony and muscular pelvis is highly interconnected to the hip and gluteal musculature, which together provide support to the internal organs and core muscles...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28660835/rectal-foreign-body-insertion-as-a-rare-cause-of-persistent-lumbosacral-plexus-injury
#5
F A Meister, I Amygdalos, U P Neumann, G Lurje
Rectal foreign body insertion is a common condition in emergency surgery, which often requires surgical intervention. Here we report a clinical case of rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury. A 72-year-old man presented to the emergency department complaining of acute bilateral paraplegia with loss of sensation in both legs, as well as total urinary retention. The patient underwent abdominal computed tomography, which showed a rectal foreign body measuring 13 × 11...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28658039/radiographic-analysis-of-psoas-morphology-and-its-association-with-neurovascular-structures-at-l4-5-with-reference-to-lateral-approaches
#6
Philip K Louie, Ankur S Narain, Fady Y Hijji, Alem Yacob, Kelly H Yom, Frank M Phillips, Kern Singh
STUDY DESIGN: Retrospective imaging review. OBJECTIVE: Utilize magnetic resonance imaging (MRI) to expand the anatomical description of psoas morphology and its association with neurovascular structures at L4-5. SUMMARY OF BACKGROUND DATA: Anatomical psoas muscle variants may present a greater risk of neurovascular injury at the L4-5 level during lateral transpsoas approaches. METHODS: Axial L4-5 sections of consecutive patients who obtained lumbar MRIs were analyzed...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28620719/large-coverage-mr-neurography-in-cidp-diagnostic-accuracy-and-electrophysiological-correlation
#7
Moritz Kronlage, Philipp Bäumer, Kalliopi Pitarokoili, Daniel Schwarz, Véronique Schwehr, Tim Godel, Sabine Heiland, Ralf Gold, Martin Bendszus, Min-Suk Yoon
The objective of this study was to evaluate large coverage magnetic resonance neurography (MRN) in chronic inflammatory demyelinating polyneuropathy (CIDP). In this prospective study, 18 patients with CIDP and 18 healthy controls were examined by a standardized MRN protocol at 3 T. Lumbosacral plexus was imaged by a T2-weighted 3D sequence and peripheral nerves of the upper and lower extremity by axial T2-weighted turbo spin-echo sequences. Lesions were characterized by nerve cross-sectional area (CSA) and T2-weighted signal (nT2)...
July 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28579881/impacts-of-triamcinolone-acetonide-on-femoral-head-chondrocytic-structures-in-lumbosacral-plexus-block
#8
Dashou Wang, Qian Chen, Fengjun Cai, Qi Pan, Xuesong Li, Qianming Wu, Yong Gan, Fei Meng, Ping Luo
Objective: To investigate impacts of triamcinolone acetonide (TRI) on femoral head chondrocytic (FHC) structures when used for lumbosacral plexus block (LPB). Methods: A total of 32 6-month-old New Zealand white rabbits were selected (averagely weighing 2.75-3.25 kg) and added TRI into nerve block solution for LPB. The rabbit were randomly divided into four groups: group A1: 2.5 ml × 2 times, group A2 2.5 ml × 4 times, group B1 5 ml × 2 times, and group B2 5 ml × 4 times; the time interval among the injection was 5 days, and the structural changes of FHC were the observed using 50/100/200 light microscope; the modified Mankin pathological scoring was also performed for the evaluation...
May 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28560607/femoral-nerve-and-lumbar-plexus-injury-after-minimally-invasive-lateral-retroperitoneal-transpsoas-approach-electrodiagnostic-prognostic-indicators-and-a-roadmap-to-recovery
#9
Naomi A Abel, Jacob Januszewski, Andrew C Vivas, Juan S Uribe
Injury to the lumbosacral (LS) plexus is a well-described complication after lateral retroperitoneal transpsoas approaches to the spine. The prognosis for functional recovery after lumbosacral plexopathy or femoral/obturator neuropathy is unclear. We designed a retrospective case-control study with patients undergoing one-level lateral retroperitoneal transpsoas lumbar interbody fusion (LLIF) between January 2011 and June 2016 to correlate electrodiagnostic assessments (EDX) to physiologic concepts of nerve injury and reinnervation, and attempt to build a timeline for patient evaluation and recovery...
May 30, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28528897/lateral-lumbar-interbody-fusion-at-the-lumbosacral-junction
#10
Timothy L T Siu, Kainu Lin
Due to the obstruction of the iliac crest and the retroperitoneal vessels, lateral lumbar interbody fusion (LLIF) is generally considered contraindicated at the lumbosacral junction (LSJ). In particular the 'rise' of the psoas from the vertebral column in the lower lumbar segments has been associated with significant overlap of the lumbar plexus with the vertebral body and exclusion of a safe transpsoas entry. However in selected individuals anatomical variations may help circumvent the difficulties and the anatomical corridor posterior to the lumbar plexus may provide an alternative to the conventional anterior approach...
May 18, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28520565/use-of-a-tilting-orthopedic-fracture-table-to-facilitate-proper-patient-positioning-during-intrathecal-neurolysis-with-hyperbaric-phenol-a-case-report
#11
Nathaniel H Loo, Gerald Matchett
We describe the case of a 41-year-old woman with metastatic cervical cancer and a large mass eroding into the pelvis and left lumbosacral plexus. The patient had intractable left lower extremity pain refractory to standard therapies, and she elected to undergo intrathecal neurolysis. A diagnostic intrathecal block was performed at the T11-12 interspace followed by intrathecal neurolysis with 6% phenol in glycerin on a subsequent date. During both procedures, we used a tilting radiolucent orthopedic fracture table to maintain strict left lateral-supine positioning...
May 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28506346/-role-of-short-latency-somatosensory-evoked-potential-in-the-diagnosis-of-chronic-inflammatory-demyelinating-polyneuropathy
#12
Rui-Di Sun, Bing Fu, Jun Jiang
OBJECTIVE: To investigate the role of short-latency somatosensory evoked potential (SSEP) in the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). METHODS: A total of 48 children with a confirmed or suspected CIDP and 40 healthy children were enrolled. Nerve electrophysiological examination and/or SSEP examination was performed (the children in the healthy control group only underwent SSEP examination). Four-lead electromyography was used for nerve electrophysiological examination, including at least 4 motor nerves and 2 sensory nerves...
May 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28473078/acr-appropriateness-criteria-%C3%A2-plexopathy
#13
Julie Bykowski, Joseph M Aulino, Kevin L Berger, R Carter Cassidy, Asim F Choudhri, A Tuba Kendi, Claudia F E Kirsch, Michael D Luttrull, Aseem Sharma, Vilaas S Shetty, Khoi Than, Christopher J Winfree, Rebecca S Cornelius
MRI without and with contrast is the most accurate imaging method to determine whether a process is intrinsic or extrinsic to a nerve of the brachial or lumbosacral plexus. However, there are no Current Procedural Terminology codes to correspond to imaging studies of the brachial or lumbar plexus discretely. This assessment uses "MRI of the brachial plexus" or "MRI of the lumbosacral plexus" as independent entities given that imaging acquisition for the respective plexus differs in sequences and planes compared with those of a routine neck, chest, spine, or pelvic MRI, yet acknowledges the potential variability of ordering practices across institutions...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28429700/acute-lower-extremity-paralysis-after-lower-extremity-endovascular-intervention
#14
Semi Öztürk, Muhsin Kalyoncuoğlu, Gündüz Durmuş, Adem Topçu, Mehmet Can
A 61-year-old man underwent successful percutaneous revascularization of both lower limbs with multiple stent implantations. Paralysis of right lower limb was noticed after completion of procedure when transferring the patient from angiography table. Since hematoma compressing lumbosacral neural plexus could be a fatal complication, computed tomography (CT) image was taken. CT showed bulge of distended bladder compressing stent struts. Following placement of Foley catheter, condition improved and he was subsequently discharged uneventfully...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28396863/real-time-ultrasound-mri-fusion-for-suprasacral-parallel-shift-approach-to-lumbosacral-plexus-blockade-and-analysis-of-injectate-spread-an-exploratory-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Jennie Maria Christin Strid, Erik Morre Pedersen, Sinan Naseer Hussain Al-Karradi, Mathias Alrø Fichtner Bendtsen, Siska Bjørn, Mette Dam, Morten Daugaard, Martin Sejr Hansen, Katrine Danker Linnet, Jens Børglum, Kjeld Søballe, Thomas Fichtner Bendtsen
Fused real-time ultrasound and magnetic resonance imaging (MRI) may be used to improve the accuracy of advanced image guided procedures. However, its use in regional anesthesia is practically nonexistent. In this randomized controlled crossover trial, we aim to explore effectiveness, procedure-related outcomes, injectate spread analyzed by MRI, and safety of ultrasound/MRI fusion versus ultrasound guided Suprasacral Parallel Shift (SSPS) technique for lumbosacral plexus blockade. Twenty-six healthy subjects aged 21-36 years received two SSPS blocks (20 mL 2% lidocaine-epinephrine [1 : 200,000] added 1 mL diluted contrast) guided by ultrasound/MRI fusion versus ultrasound...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28383293/peripheral-nerve-block-as-a-supplement-to-light-or-deep-general-anesthesia-in-elderly-patients-receiving-total-hip-arthroplasty-a-prospective-randomized-study
#16
Bin Mei, Hanning Zha, Xiaolong Lu, Xinqi Cheng, Shishou Cheng, Xuesheng Liu, Yuanhai Li, Erwei Gu
BACKGROUND: Peripheral nerve block combined with general anesthesia is a preferable anesthesia method for elderly patients receiving hip arthroplasty. The depth of sedation may influence patient recovery. Therefore, we aimed to investigate the influence of peripheral nerve blockade and different intraoperative sedation levels on the short-term recovery of elderly patients receiving total hip arthroplasty. METHODS: Patients aged 65 years and older undergoing total hip arthroplasty were randomized into three groups: a general anesthesia without lumbosacral plexus block group, and two general anesthesia plus lumbosacral plexus block groups, each with a different level of sedation (light or deep)...
April 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28375661/pain-management-of-malignant-psoas-syndrome-under-epidural-analgesia-during-palliative-radiotherapy
#17
Takayo Ota, Masaru Makihara, Hiroshi Tsukuda, Ryuji Kajikawa, Masayuki Inamori, Nozomi Miyatake, Noriko Tanaka, Masahiro Tokunaga, Yoshikazu Hasegawa, Takuhito Tada, Masahiro Fukuoka
Malignant psoas syndrome is a rare malignant condition presenting as lumbosacral plexopathy and painful fixed flexion of the hip. Metastasis to the psoas muscle is observed, which damages the nerve bundles in the lumbosacral plexuses. The syndrome presents as refractory lower back pain with several other neurological symptoms. The pain is difficult to control because it is a mixture of nociceptive and neuropathic pain, which indicates that treatment requires a versatile approach. The authors report a case of severe back pain caused by metastasis to the psoas muscle of advanced gastric cancer in a patient who underwent palliative radiotherapy under epidural analgesia...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28357568/high-resolution-metal-artifact-reduction-mr-imaging-of-the-lumbosacral-plexus-in-patients-with-metallic-implants
#18
Shivani Ahlawat, Steven E Stern, Allan J Belzberg, Jan Fritz
OBJECTIVE: To assess the quality and accuracy of metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) for the diagnosis of lumbosacral neuropathies in patients with metallic implants in the pelvis. MATERIALS AND METHODS: Twenty-two subjects with lumbosacral neuropathy following pelvic instrumentation underwent 1.5-T MARS MRI including optimized axial intermediate-weighted and STIR turbo spin echo sequences extending from L5 to the ischial tuberosity...
July 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28339446/pulsed-radiofrequency-ablation-of-pudendal-nerve-for-treatment-of-a-case-of-refractory-pelvic-pain
#19
Vadim Petrov-Kondratov, Avneesh Chhabra, Stephanie Jones
Pudendal neuralgia (PN) is a result of pudendal nerve entrapment or injury, also called "Alcock syndrome." Pain that develops is often chronic, and at times debilitating. If conservative measures fail, invasive treatment modalities can be considered. The goal of this case report is to add to a small body of literature that a pulsed radiofrequency (PRF) ablation can be effectively used to treat PN and to show that high resolution MR neurography imaging can be used to detect pudendal neuropathy. CASE PRESENTATION: We present a case of a 51-year-old woman with 5 years of worsening right groin and vulva pain...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28247042/neuralgic-amyotrophy-triggered-by-hepatitis-e-virus-a-particular-phenotype
#20
REVIEW
Quentin Scanvion, Thierry Perez, François Cassim, Olivier Outteryck, Aurélia Lanteri, Pierre-Yves Hatron, Marc Lambert, Sandrine Morell-Dubois
The neuralgic amyotrophy may be of difficult diagnosis, due to phenotypic variability, with different initial presentations (upper plexus multiple mononeuropathy, lumbosacral involvement, distal reached, phrenic involvement). To date, there is little guidance on these patients' therapeutic management, especially those for which neuralgic amyotrophy is triggered by hepatitis E virus (HEV-NA). The study aims to identify specific features that characterize patients bearing the neuralgic amyotrophy triggered by HEV...
April 2017: Journal of Neurology
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