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https://www.readbyqxmd.com/read/28620719/large-coverage-mr-neurography-in-cidp-diagnostic-accuracy-and-electrophysiological-correlation
#1
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)...
June 15, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28579881/impacts-of-triamcinolone-acetonide-on-femoral-head-chondrocytic-structures-in-lumbosacral-plexus-block
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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