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https://www.readbyqxmd.com/read/28429700/acute-lower-extremity-paralysis-after-lower-extremity-endovascular-intervention
#1
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
#2
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
#3
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
#4
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...
April 4, 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
#5
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...
March 30, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28339446/pulsed-radiofrequency-ablation-of-pudendal-nerve-for-treatment-of-a-case-of-refractory-pelvic-pain
#6
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
#7
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...
February 28, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28245730/peripheral-nervous-system-injury-after-high-dose-single-fraction-image-guided-stereotactic-radiosurgery-for-spine-tumors
#8
Michael D Stubblefield, Katarzyna Ibanez, Elyn R Riedel, Ori Barzilai, Ilya Laufer, Eric Lis, Yoshiya Yamada, Mark H Bilsky
OBJECTIVE The object of this study was to determine the percentage of high-dose (1800-2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between January 2004 and May 2013 and referred to the Rehabilitation Medicine Service for evaluation and treatment of neuromuscular, musculoskeletal, or functional impairments or pain were retrospectively identified...
March 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28213852/-imaging-of-the-lumbosacral-plexus-diagnostics-and-treatment-planning-with-high-resolution-procedures
#9
S Jengojan, C Schellen, G Bodner, G Kasprian
BACKGROUND: Technical advances in magnetic resonance (MR) and ultrasound-based neurography nowadays facilitate the radiological assessment of the lumbosacral plexus. OBJECTIVE: Anatomy and imaging of the lumbosacral plexus and diagnostics of the most common pathologies. MATERIAL AND METHODS: Description of the clinically feasible combination of magnetic resonance imaging (MRI) and ultrasound diagnostics, case-based illustration of imaging techniques and individual advantages of MRI and ultrasound-based diagnostics for various pathologies of the lumbosacral plexus and its peripheral nerves...
February 17, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28212784/intraspinal-extradural-variations-of-nerve-roots
#10
Viktor Matejčík, Zora Haviarová, Andrej Šteňo, Roman Kuruc, Juraj Šteňo
INTRODUCTION: The aim of this work is to point out the intraspinal extradural anatomical variations of nerve roots and their possible participation in radiculopathy. METHODS: The anatomical study was performed in 33 cadavers at a mean age of 46.5 and up to 24h from death. All extradural anastomoses between nerve roots were excised and examined histologically for the presence or absence of nervous tissue. The type of the plexus was defined by subtracting from the root C2...
March 5, 2017: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/28202486/granulocytic-sarcoma-a-rare-cause-of-sciatica
#11
Epaminondas Markos Valsamis, Thomas Edward Glover
We describe a case report of a man aged 56 years with a 4-month history of right-sided sciatica-type pain with subclinical disc prolapse evident on MRI. Worsening pain together with the appearance of a tender mass in his right buttock prompted further imaging, which demonstrated an infiltrative mass engulfing the lumbosacral plexus. This was later shown to be a granulocytic sarcoma on biopsy. Intervertebral disc herniation can be an incidental finding and is not always the cause of sciatica.
February 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28140423/obstetrisk-nervp%C3%A3-verkan-%C3%A3-r-oftast-inte-ryggbed%C3%A3-vningens-fel
#12
Lovisa Brehmer, Johan Rutfors
Postpartum nerve injury is usually not caused by neuroaxial anesthesia - a case report In this case report we describe a woman who after giving birth had numbness and could not support her weight on the right leg. Three attempts of epidural anesthesia had been made during labor. MRI imaging of the spinal cord showed no pathology. She was treated conservatively by a physiotherapist and recovered gradually. After six months all symptoms had resolved. Postpartum nerve injury is often thought to be due to neuroaxial anesthesia, although in most cases it is caused by labor itself...
January 27, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28102579/anatomical-organization-and-somatic-axonal-components-of-the-lumbosacral-nerves-in-female-rabbits
#13
Yolanda Cruz, Isela Hernández-Plata, Rosa Angélica Lucio, René Zempoalteca, Francisco Castelán, Margarita Martínez-Gómez
AIM: To determine the anatomical organization and somatic axonal components of the lumbosacral nerves in female rabbits. METHODS: Chinchilla adult anesthetized female rabbits were used. Anatomical, electrophysiological, and histological studies were performed. RESULTS: L7, S1, and some fibers from S2 and S3 form the lumbosacral trunk, which gives origin to the sciatic nerve and innervation to the gluteal region. From S2 to S3 originates the pudendal nerve, whose branches innervates the striated anal and urethra sphincters, as well as the bulbospongiosus, ischiocavernosus, and constrictor vulvae muscles...
January 19, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28059708/impact-of-mr-neurography-in-patients-with-chronic-cauda-equina-syndrome-presenting-as-chronic-pelvic-pain-and-dysfunction
#14
J R Petrasic, A Chhabra, K M Scott
BACKGROUND AND PURPOSE: Chronic cauda equina syndrome, defined as persistent damage of the cauda equina nerve roots within the spinal canal can be a challenging diagnosis with varied presentations. MR neurography imaging is more commonly being used to evaluate the lumbosacral spine of patients suspected of having subacute or chronic cauda equina syndrome. Our aim was to evaluate the impact of lumbosacral plexus MR neurography in the diagnostic thinking and therapeutic management of patients presenting with chronic pelvic pain and dysfunction and suspected chronic cauda equina syndrome...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27884744/technical-description-of-oblique-lateral-interbody-fusion-at-l1-l5-olif25-and-at-l5-s1-olif51-and-evaluation-of-complication-and-fusion-rates
#15
Kamal R M Woods, James B Billys, Richard A Hynes
BACKGROUND: The OLIF procedure is aimed at mitigating some of the challenges seen with traditional ALIF and transpsoas LLIF and allows for interbody fusion at L1-S1. PURPOSE: To describe the OLIF technique and assess the complication and fusion rates. STUDY DESIGN: A retrospective cohort study. PATIENT SAMPLE: 137 patients who underwent the oblique lateral interbody fusion (OLIF) procedure. OUTCOME MEASURES: Adverse events within 6 months of surgery: Infection, symptomatic pseudarthrosis, hardware failure, vascular injury, perioperative blood transfusion, ureteral injury, bowel injury, renal injury, prolonged postoperative ileus (greater than 3 days), incisional hernia, pseudohernia, reoperation, neurological deficits (weakness, numbness, paresthesia), hip flexion pain, retrograde ejaculation, sympathectomy affecting lower extremities, deep vein thrombosis, pulmonary embolism, myocardial infarction, pneumonia, and cerebrovascular accident...
November 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27843679/high-neurological-complication-rates-for-extreme-lateral-lumbar-interbody-fusion-and-related-techniques-a-review-of-safety-concerns
#16
Nancy E Epstein
BACKGROUND: There are frequent reports of lumbosacral plexus and other neurological injuries occurring with extreme lateral interbody fusions (XLIF) and other related lateral lumbar techniques. METHODS: This review focuses on the new neurological deficits (e.g. lumbosacral plexus, root injuries) that occur following minimally invasive surgery (MIS) XLIF and other related lateral lumbar techniques. RESULTS: A review of multiple articles revealed the following ranges of new postoperative neurological complications for XLIF procedures: plexus injuries 13...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27707614/extreme-lateral-interbody-fusion-relieves-symptoms-of-spinal-stenosis-and-low-grade-spondylolisthesis-by-indirect-decompression-in-complex-patients
#17
Erlick A C Pereira, Mohammad Farwana, Khai S Lam
Spinal stenosis and low-grade spondylolisthesis produce symptoms of neural compression that can be treated with extreme lateral lumbar interbody fusion (XLIF) via indirect decompression. This study aimed to investigate whether the restoration of disc dimensions would relieve symptoms of radiculopathy, claudication and back pain. In this retrospective study, patients undergoing XLIF surgery for relief of radicular symptoms or degenerative disc disease were included. Radiologically proven changes were used to assess the modes of degeneration...
January 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27706667/expression-and-distribution-of-sp-and-its-nk1-receptor-in-the-brain-gut-axis-in-neonatal-maternally-separated-rat-model-with-visceral-hypersensitivity
#18
W Teng, H Chen, F Guo, X Du, X Fu, Y Fang, H Zhang, M Fang, M Ding
Neurokinin-1 receptor (NK1R) is a high affinity Substance P (SP) receptor and plays a key role in visceral hypersensitivity in irritable bowel syndrome (IBS). Early life stress is a significant risk factor in IBS. The aim of the present study was to investigate the influence of neonatal maternal separation on the expression and distribution of SP and its receptor along the brain-gut axis in a neonatal maternally separated rat model with visceral hypersensitivity. Male neonatal Sprague-Dawley rats, 2-21-day old, were randomly distributed into maternal separation groups of 3 h daily maternal separation (MS) or non-handling (NH)...
August 30, 2016: Genetics and Molecular Research: GMR
https://www.readbyqxmd.com/read/27607166/a-unique-case-of-erdheim-chester-disease-with-cervical-and-lumbosacral-nerve-involvement-fdg-pet-ct-finding
#19
Na Niu, Xinxin Cao, Ruixue Cui
Cervical and lumbosacral nerve roots and plexus involvement in Erdheim-Chester disease (ECD) is rare. A 50-year-old man with progressive edema in bilateral lower extremities, numbness, weakness, and muscle atrophy of upper limb for 2 years had been misdiagnosed of neuritis or cervical spondylosis until he presented bone pain. In addition to bilateral symmetric involvement in long bones, bilateral hypermetabolism in cervical and lumbosacral nerve roots was found by FDG PET/CT scan. ECD was diagnosed by bone biopsy...
November 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27551340/3t-magnetic-resonance-neurography-of-pudendal-nerve-with-cadaveric-dissection-correlation
#20
Avneesh Chhabra, Courtney A McKenna, Vibhor Wadhwa, Gaurav K Thawait, John A Carrino, Gary P Lees, A Lee Dellon
AIM: To evaluate the pudendal nerve segments that could be identified on magnetic resonance neurography (MRN) before and after surgical marking of different nerve segments. METHODS: The hypothesis for this study was that pudendal nerve and its branches would be more easily seen after the surgical nerve marking. Institutional board approval was obtained. One male and one female cadaver pelvis were obtained from the anatomy board and were scanned using 3 Tesla MRI scanner using MR neurography sequences...
July 28, 2016: World Journal of Radiology
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