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https://www.readbyqxmd.com/read/29914899/varicella-zoster-lumbosacral-plexopathy-a-rare-cause-of-lower-limb-weakness
#1
Timothy Michael Archer
This is a rare case of Varicella zoster virus (VZV) lumbosacral plexopathy in an 84-year-old women presenting with lower limb weakness and rash. Contrast-enhanced MRI showed enhancement of the left L3-L5 descending nerves and left lumbosacral plexus consistent with inflammatory/infectious aetiology. Cerebrospinal fluid PCR confirmed VZV DNA and cerebrospinal fluid serological testing was positive for VZV immunoglobulin (Ig)M and IgG antibodies. The patient was treated with intravenous acyclovir but this was complicated by the development of acute renal failure attributed to acyclovir-induced nephropathy, requiring dose adjustment...
June 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29877751/differential-diagnosis-of-knee-pain-following-a-surgically-induced-lumbosacral-plexus-stretch-injury-a-case-report
#2
William R VanWye, Harvey W Wallmann, Elizabeth S Norris, Karen E Furgal
BACKGROUND AND PURPOSE: Knee joint biomechanics requires an understanding of lower extremity (LE) segmental interactions. In some cases, knee pain may arise as a result of altered LE biomechanics; while in other cases, knee pain may stem from other causes, such as a peripheral nerve injury. CASE DESCRIPTION: A 33-year-old woman presented via direct access for physical therapist (PT) examination with a chief complaint of left knee pain. The day after undergoing a dilation and curettage (D&C) procedure the patient had an acute onset of gait dysfunction...
June 7, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29846365/magnetic-resonance-neurography-of-the-lumbosacral-plexus-in-failed-back-surgery-syndrome
#3
Riham Dessouky, Mohammed Khaleel, Dalia N Khalifa, Hazim I Tantawy, Avneesh Chhabra
STUDY DESIGN: Retrospective clinical case series. OBJECTIVE: To study the role of magnetic resonance neurography (MRN) of the lumbosacral plexus in management of patients with failed back surgery syndrome (FBSS). SUMMARY OF BACKGROUND DATA: FBSS is one of the major problems in health care, affecting up to 40% of patients after spine surgery. To date, no imaging modality has been used to effectively classify nerve compression, because nerve injuries are challenging to detect on conventional lumbar spine magnetic resonance imaging (MRI)...
June 15, 2018: Spine
https://www.readbyqxmd.com/read/29794574/lumbosacral-radiculoplexopathy-as-the-initial-presentation-of-lymphoma-a-report-of-4-cases
#4
Robert J Marquardt, Yuebing Li
OBJECTIVES: To evaluate the clinical, laboratory, and radiological features of 4 cases of biopsy-proven lymphomatous lumbosacral radiculoplexopathy. METHODS: Retrospective chart review. RESULTS: All patients suffered from diffuse large B-cell lymphoma. A mean diagnostic delay of 10 months was encountered. Presenting symptoms in all 4 patients included back pain, radicular leg pain, and leg weakness, similar to spondylotic radiculopathy. Electrodiagnostic study showed axon loss radiculoplexopathy and magnetic resonance imaging of the lumbar spine or pelvis demonstrated nerve or nerve root enhancement...
June 2018: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/29714660/second-pelvic-recurrence-of-rectal-cancer-successfully-treated-with-a-re-reirradiation-3rd-radiation-course
#5
Veronica Dell'Acqua, Annamaria Ferrari, Delia Ciardo, Gaia Piperno, Sabrina Vigorito, Mariacristina Leonardi, Samantha Dicuonzo, Roberto Orecchia, Barbara Alicja Jereczek-Fossa
In case of pelvic recurrence of colorectal cancer, reirradiation of previously irradiated patients may increase the rate of salvage radical resection. Due to the high cumulative dose, one of the main concerns is radiation-induced lumbosacral plexopathy. This report describes multiple irradiations of a lesion adjacent to the lumbosacral plexus, using a highly selective technique, which allows optimal sparing of such a critical structure. Case description A 53-year-old woman treated in 2008 for a locally advanced rectal adenocarcinoma with preoperative pelvic irradiation and concomitant chemotherapy followed by surgery had disease recurrence in 2011 and underwent a second course of pelvic radiotherapy...
April 1, 2018: Tumori
https://www.readbyqxmd.com/read/29702268/vascular-entrapment-of-both-the-sciatic-and-pudendal-nerves-causing-persistent-sciatica-and-pudendal-neuralgia
#6
Ahmet Kale, Gulfem Basol, Taner Usta, Isa Cam
STUDY OBJECTIVE: To demonstrate the laparoscopic approach to malformed branches of the vessels entrapping the nerves of the sacral plexus. DESIGN: A step-by-step explanation of the surgery using video (educative video) (Canadian Task force classification II). The university's Ethics Committee ruled that approval was not required for this video. SETTING: Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey. PATIENT: A 26-year-old patient who had failed medical therapy and presented with complaints of numbness and burning pain on the right side of her vagina and pain radiating to her lower limbs for a period of approximately 36 months...
April 24, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29662907/demystifying-mr-neurography-of-the-lumbosacral-plexus-from-protocols-to-pathologies
#7
REVIEW
Francisco J Muniz Neto, Eduardo N Kihara Filho, Frederico C Miranda, Laercio A Rosemberg, Durval C B Santos, Atul K Taneja
Magnetic resonance neurography is a high-resolution imaging technique that allows evaluating different neurological pathologies in correlation to clinical and the electrophysiological data. The aim of this article is to present a review on the anatomy of the lumbosacral plexus nerves, along with imaging protocols, interpretation pitfalls, and most common pathologies that should be recognized by the radiologist: traumatic, iatrogenic, entrapment, tumoral, infectious, and inflammatory conditions. An extensive series of clinical and imaging cases is presented to illustrate key-points throughout the article...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29660549/perineural-spread-along-spinal-and-obturator-nerves-in-primary-vaginal-carcinoma-a-case-report
#8
Eun Jee Song, Ji Seon Park, Kyung Nam Ryu, So Young Park, Wook Jin
BACKGROUND: Perineural spread is not uncommon feature in carcinoma of the head and neck. On the contrary, perineural spread in pelvic malignancies has been rarely reported. This report is the first report about perineural spread of obturator nerve and lumbosacral plexus from primary vaginal cancer. CASE DESCRIPTION: A 50-year-old woman diagnosed with infectious spondylitis at an outside hospital was referred to our institution. She presented with persistent lower back pain and right anterior thigh pain...
April 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29581014/magnetic-resonance-neurography-in-chronic-lumbosacral-and-pelvic-pain-diagnostic-and-management-impact-institutional-audit
#9
Riham Dessouky, Yin Xi, Kelly M Scott, Mohammed Khaleel, Kevin Gill, Stephanie Jones, Dalia N Khalifa, Hazim I Tantawy, Magdy A Aidaros, Avneesh Chhabra
BACKGROUND/OBJECTIVE: Low back and pelvic pain are among the most prevalent conditions worldwide, with major social and economic costs. The aim of this study was to evaluate the role of magnetic resonance neurography (MRN) of lumbosacral plexus in the management and outcomes of these patients with chronic pain. METHODS: Consecutive patients with chronic lumbosacral and pelvic pain referred for MRN over a year were included. Preimaging and postimaging clinical diagnosis and treatment, pain levels, and location were recorded...
June 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29575220/lumbosacral-plexus-root-thickening-establishing-normal-root-dimensions-using-magnetic-resonance-neurography
#10
Hernán Chaves, Mariana Bendersky, Romina Goñi, César Gómez, Martín Carnevale, Claudia Cejas
INTRODUCTION: Disorders affecting the lumbosacral plexus (LSP) can alter root diameter. Our aim was to determine normal LSP nerve root dimensions using magnetic resonance neurography (MRN). MATERIALS AND METHODS: Eleven asymptomatic patients (ages: 18-53, mean: 34 years) underwent MRN of the LSP on a 3T scanner with an 8-channel torso-PA coil. IDEAL T2-weighted images were acquired and nerve root dimensions were measured from the second lumbar (L2) to the first sacral (S1) vertebrae on the coronal plane, 5 mm from the dorsal root ganglion (DRG)...
March 25, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29536189/posterior-resection-of-fifth-lumbar-giant-schwannoma-combined-with-a-recapping-transiliac-approach-case-report-and-technical-note
#11
Hitoshi Tonomura, Yoichiro Hatta, Masateru Nagae, Ryota Takatori, Toshikazu Kubo
A two-stage combined anterior and posterior approach is commonly used for total resection of giant spinal tumors. However, an anterior approach at the lower lumbar level is technically challenging because of the anatomy of the iliac wing, major vessels and nerves of the lumbosacral plexus. We report a case of fifth vertebral tumor treated posteriorly with a newly devised surgical procedure combined with a recapping transiliac approach. A 45-year-old female diagnosed with giant schwannoma of the fifth lumbar vertebra underwent single-stage posterior tumor resection combined with osteotomy of the lateral part of the iliac crest...
March 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29528863/intraoperative-sedation-with-dexmedetomidine-is-superior-to-propofol-for-elderly-patients-undergoing-hip-arthroplasty-a-prospective-randomized-controlled-study
#12
Bin Mei, Gaige Meng, Guanghong Xu, Xinqi Cheng, Shishou Chen, Ye Zhang, Ming Zhang, Xuesheng Liu, Erwei Gu
BACKGROUND: Peripheral nerve block is a preferable method for elderly patients receiving hip arthroplasty. Sedation with dexmedetomidine may reduce postoperative delirium. The aim of this study was to investigate whether intraoperative sedation with dexmedetomidine, as a supplementary to peripheral nerve block for elderly patients receiving total hip arthroplasty, can decrease the prevalence of postoperative delirium. METHODS: A prospective, randomized controlled study was conducted with patients 65 years of age or older who underwent total hip arthroplasty between June 2016 and June 2017...
March 9, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29492369/two-year-outcomes-from-a-single-surgeon-s-learning-curve-experience-of-oblique-lateral-interbody-fusion-without-intraoperative-neuromonitoring
#13
Kamal Woods, Ahtziri Fonseca, Larry E Miller
Introduction Oblique lumbar interbody fusion (OLIF) is a newer procedure that avoids the psoas and lumbosacral plexus due to its oblique trajectory into the retroperitoneal space. While early experience with OLIF is reassuring, the longer-term clinical efficacy has not been well established. The purpose of this study was to describe two-year clinical outcomes with OLIF performed by a single surgeon during the learning curve without the aid of the neuromonitoring. Materials and methods Chart review was performed for the consecutive patients who underwent OLIF by a single surgeon...
December 22, 2017: Curēus
https://www.readbyqxmd.com/read/29468291/lymphangiomatosis-a-rare-entity-presenting-with-involvement-of-the-sacral-plexus
#14
Megan K Mills, Bryn Putbrese, Hailey Allen, Sarah E Stilwill
Lymphangiomatosis is an uncommon disease process characterized by multisystem lymphatic malformations that can involve numerous body systems, including organs, muscles, soft tissues, and bones. Involvement of the nervous system is rare and has even been previously described as a site of sparing. We present a case of a 24-year-old female with known lymphangiomatosis, presenting with acute onset of lower extremity paresthesias, weakness, and new urinary retention. MRI of the pelvis revealed lymphangiomatosis of the sacral plexus, which has not been previously reported...
February 21, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29455410/can-patients-with-symptomatic-tarlov-cysts-be-differentiated-from-patients-with-specific-low-back-pain-based-on-comprehensive-history-taking
#15
Maria Anna Hulens, Wim Dankaerts, Ricky Rasschaert, Frans Bruyninckx, Marie-Laure Willaert, Charlotte Vereecke, Greet Vansant
BACKGROUND: Tarlov cysts (TCs) are expanded nerve root sheaths that occur near the dorsal root ganglion and result from increased intraspinal hydrostatic pressure. TCs most frequently affect the lumbosacral plexus and therefore may cause specific symptoms such as perineal pain and neurogenic bladder, bowel, and sphincter problems. It has been estimated that 1% of the population has symptomatic Tarlov cysts (STCs). However, STCs appear to be underdiagnosed, with the pain reported by patients commonly attributed to degenerative alterations seen on MRI...
April 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29435745/a-step-towards-stereotactic-navigation-during-pelvic-surgery-3d-nerve-topography
#16
A R Wijsmuller, C Giraudeau, J Leroy, G J Kleinrensink, E Rociu, L G Romagnolo, A G F Melani, V Agnus, M Diana, L Soler, B Dallemagne, J Marescaux, D Mutter
BACKGROUND: Long-term morbidity after multimodal treatment for rectal cancer is suggested to be mainly made up by nerve-injury-related dysfunctions. Stereotactic navigation for rectal surgery was shown to be feasible and will be facilitated by highlighting structures at risk of iatrogenic damage. The aim of this study was to investigate the ability to make a 3D map of the pelvic nerves with magnetic resonance imaging (MRI). METHODS: A systematic review was performed to identify a main positional reference for each pelvic nerve and plexus...
February 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29323028/surgical-reconstruction-of-spinal-cord-circuit-provides-functional-return-in-humans
#17
REVIEW
Thomas Carlstedt, Nicholas James, Mårten Risling
This mini review describes the current surgical strategy for restoring function after traumatic spinal nerve root avulsion in brachial or lumbosacral plexus injury in man. As this lesion is a spinal cord or central nervous injury functional return depends on spinal cord nerve cell growth within the central nervous system. Basic science, clinical research and human application has demonstrated good and useful motor function after ventral root avulsion followed by spinal cord reimplantation. Recently, sensory return could be demonstrated following spinal cord surgery bypassing the injured primary sensory neuron...
December 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29322233/high-isotropic-resolution-t2-mapping-of-the-lumbosacral-plexus-with-t2-prepared-3d-turbo-spin-echo
#18
Nico Sollmann, Dominik Weidlich, Barbara Cervantes, Elisabeth Klupp, Carl Ganter, Hendrik Kooijman, Ernst J Rummeny, Claus Zimmer, Jan S Kirschke, Dimitrios C Karampinos
PURPOSE: Isotropic high-resolution three-dimensional (3D) magnetic resonance neurography (MRN) is increasingly used to depict even small and highly oblique nerves of the lumbosacral plexus (LSP). The present study introduces a T2 mapping sequence (T2-prepared 3D turbo spin echo) that is B1-insensitive and enables quantitative assessment of LSP nerves. METHODS: In this study 15 healthy subjects (mean age 28.5 ± 3.8 years) underwent 3 T MRN of the LSP area three times...
January 10, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29249733/variations-in-the-course-of-the-superior-gluteal-artery-in-relation-to-the-lumbosacral-plexus
#19
Hidaka Anetai, Kounosuke Tokita, Ryuhei Kojima, Yukio Aizawa, Ikuo Kageyama, Katsuji Kumaki
The course of the superior gluteal artery (SGA) as it passes through the lumbosacral plexus is variable. The variations of the arterial course in relation to the lumbosacral plexus have focused on statistical analysis, and it is limited arterial diversity. In this study, we investigated the positional relation between the SGA and the furcal nerve (FN): guide to segmentation of the lumbosacral plexus, arising from the L4, ie, the contribution to the femoral nerve, obturator nerve, and lumbosacral trunk. We could classify the pathway of the SGA into three types based on its positional relation to the FN...
2017: Okajimas Folia Anatomica Japonica
https://www.readbyqxmd.com/read/29241265/retroperitoneoscopic-resection-of-a-lumbosacral-plexus-schwannoma-case-report-and-literature-review
#20
Bruno Freitas, Rui Figueiredo, Fabrício Carrerette, Marcus André Acioly
BACKGROUND AND STUDY AIMS:  Schwannomas are benign tumors derived from the Schwann cells of the peripheral nerve sheath that rarely affect the retroperitoneum. When symptomatic, surgical resection is usually recommended via open surgery or the laparoscopic transperitoneal approach. We discuss the retroperitoneoscopic resection of lumbosacral plexus schwannomas through an illustrative case and literature review. A new management classification is also proposed. PATIENTS:  A 61-year-old woman affected by schwannomatosis presented with neuropathic pain in her right inguinocrural area for the past 4 years before admission...
May 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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