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Lumbar plexus

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https://www.readbyqxmd.com/read/28619496/injury-to-the-lumbar-plexus-and-its-branches-following-lateral-fusion-procedures-a-cadaver-study
#1
Peter Grunert, Doniel Drazin, Joe Iwanaga, Cameron Schmidt, Fernando Alonso, Marc Moisi, Jens R Chapman, Rod J Oskouian, R Shane Tubbs
INTRODUCTION: Neurological deficits from lumbar plexus nerve injuries commonly occur in patients undergoing lateral approaches. However, it is not yet clear what types of injury occur, where anatomically they are located, or what mechanism causes them. We aimed, to study (a) the topographic anatomy of lumbar plexus nerves and their injuries in human cadavers after lateral transpsoas approaches to the lumbar spine, (b) the structural morphology of those injuries, (c) the topographic anatomy of the lumbar plexus throughout the mediolateral approach corridor...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28593626/safety-of-lateral-interbody-fusion-surgery-without-intraoperative-monitoring
#2
Hong-Jae Lee, Kyeong-Sik Ryu, Jung-Woo Hur, Ji-Hoon Seong, Hyun-Jin Cho, Jin-Sung Kim
AIM: Oblique lateral interbody fusion (OLIF) is a minimally invasive surgical method that can access lumbar spine without direct dissection of psoas muscle and the need for intraoperative neuromonitoring (IOM) is questionable. The purpose of this study is to examine and document the transient and persistent perioperative complications in patients who underwent OLIF for degenerative lumbar disease without IOM. MATERIAL AND METHODS: Total 129 consecutive patients who were diagnosed as degenerative spinal disease from L1 to S1 and underwent the mini-open OLIF, were identified and retrospectively reviewed...
May 7, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28590211/a-systematic-review-of-the-effectiveness-of-palliative-interventions-to-treat-rectal-tenesmus-in-cancer
#3
Áine Ní Laoire, Lucy Fettes, Fliss Em Murtagh
BACKGROUND: Rectal tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of tenesmus in this patient population. AIM: To identify and examine the effectiveness of interventions to palliate rectal tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options. DESIGN: A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance...
March 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28571125/preinguinal-splitting-and-reunion-of-femoral-nerve-entrapping-the-fleshy-fibres-of-iliacus-muscle-a-case-report
#4
L S Ashwini, S Nagabhooshana Somayaji, Mohandas Rao, Sapna Marpalli
Division of nerves close to their origin and muscular entrapments by nerves in the limbs is not very common. Femoral nerve is the largest branch of the lumbar plexus and arises from dorsal divisions of ventral rami of L2 to L4 spinal nerves. During routine cadaveric dissection for first year medical students at Melaka Manipal Medical College (Manipal Campus), Karnataka, India, we observed a variation in the division and course of left femoral nerve in about 65-year-old male cadaver. The femoral nerve was split into two divisions above the inguinal ligament after its origin from the lumbar plexus...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
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
#5
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/28546122/cauda-equina-syndrome-due-to-dural-sac-shift-with-engorgement-of-the-epidural-venous-plexus-rare-complication-after-lumbar-microdiscectomy
#6
Yoshinori Maki, Motohiro Takayama, Hideki Hayashi, Yohei Yokoyama, Yuji Agawa
BACKGROUND: Several postoperative complications related to lumbar microdisectomy have been reported, including cauda equina syndrome. However, to the best of our knowledge, postoperative cauda equina syndrome resulting from dural sac shift with engorgement of the epidural venous plexus is yet to be reported. CASE DESCRIPTION: A 71-year-old male patient was referred to our hospital with a chief complaint of pain and sensory disturbance due to the lumbar disc herniation of L5-S1...
May 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#7
REVIEW
Nancy E Epstein
BACKGROUND: The vast majority of studies emphasize the greater morbidity/mortality for elective spine surgery in morbidly obese patients. METHODS: This review focuses on the increased morbidity/mortality of performing elective spinal operations in morbidly obese patients. There are two definitions of morbid obesity; a body mass index (BMI) of equal to or greater than 35 plus two major comorbid factors (e.g., hypertension, diabetes, etc.) or a BMI (morbidly obese III) of =≥40 kg/m(2)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28528897/lateral-lumbar-interbody-fusion-at-the-lumbosacral-junction
#8
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/28506346/-role-of-short-latency-somatosensory-evoked-potential-in-the-diagnosis-of-chronic-inflammatory-demyelinating-polyneuropathy
#9
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/28489477/combined-sciatic-and-lumbar-plexus-nerve-blocks-for-the-analgesic-management-of-hip-arthroscopy-procedures-a-retrospective-review
#10
J Douglas Jaffe, Theodore Ross Morgan, Gregory B Russell
Hip arthroscopy is a minimally invasive alternative to open hip surgery. Despite its minimally invasive nature, there can still be significant reported pain following these procedures. The impact of combined sciatic and lumbar plexus nerve blocks on postoperative pain scores and opioid consumption in patients undergoing hip arthroscopy was investigated. A retrospective analysis of 176 patients revealed that compared with patients with no preoperative peripheral nerve block, significant reductions in pain scores to 24 hours were reported and decreased opioid consumption during the post anesthesia care unit (PACU) stay was recorded; no significant differences in opioid consumption out to 24 hours were discovered...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28473078/acr-appropriateness-criteria-%C3%A2-plexopathy
#11
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/28456736/endoscope-assisted-extreme-lateral-interbody-fusion-xlif-preliminary-experience-and-technical-note
#12
Claudio Schonauer, Martin Nikolaus Stienen, Oliver Pascal Gautschi, Karl Schaller, Enrico Tessitore
BACKGROUND: The XLIF technique is safe and effective. The deep and tight surgical corridor, however, makes visual identification of important landmark structures as well as sufficient endplate and contralateral preparation challenging. The present analysis aims to assess the safety and feasibility of endoscope-assisted (EA-) extreme lateral lumbar interbody fusion (XLIF) procedures. METHODS: Retrospective single-center study on consecutive patients undergoing XLIF procedures between 02/2014 and 07/2016...
April 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28445364/n-acetylcysteine-prevents-retrograde-motor-neuron-death-after-neonatal-peripheral-nerve-injury
#13
Joseph Catapano, Jennifer Zhang, David Scholl, Cameron Chiang, Tessa Gordon, Gregory H Borschel
BACKGROUND: Neuronal death may be an overlooked and unaddressed component of disability following neonatal nerve injuries, such as obstetric brachial plexus injury. N-acetylcysteine and acetyl-L-carnitine improve survival of neurons after adult nerve injury, but it is unknown whether they improve survival after neonatal injury, when neurons are most susceptible to retrograde neuronal death. The authors' objective was to examine whether N-acetylcysteine or acetyl-L-carnitine treatment improves survival of neonatal motor or sensory neurons in a rat model of neonatal nerve injury...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28444825/3-tesla-magnetic-resonance-imaging-study-of-the-normal-canine-femoral-and-sciatic-nerves
#14
Christine Sievert, Henning Richter, Dominic Gascho, Patrick R Kircher, Inés Carrera
Understanding the normal course and optimizing visualization of the canine peripheral nerves of the lumbar plexus, in particular the sciatic and the femoral nerves, is essential when interpreting images of patients with suspected peripheral neuropathies such as inflammatory or neoplastic conditions. The purpose of this prospective, anatomic study was to describe the magnetic resonance imaging (MRI) anatomy of the normal canine femoral and sciatic nerves and to define the sequences in which the nerves are best depicted...
April 25, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28420598/1-5-t-augmented-reality-navigated-interventional-mri-paravertebral-sympathetic-plexus-injections
#15
David R Marker, Paweena U Thainual, Tamas Ungi, Aaron J Flammang, Gabor Fichtinger, Iulian I Iordachita, John A Carrino, Jan Fritz
PURPOSE: The high contrast resolution and absent ionizing radiation of interventional magnetic resonance imaging (MRI) can be advantageous for paravertebral sympathetic nerve plexus injections. We assessed the feasibility and technical performance of MRI-guided paravertebral sympathetic injections utilizing augmented reality navigation and 1.5 T MRI scanner. METHODS: A total of 23 bilateral injections of the thoracic (8/23, 35%), lumbar (8/23, 35%), and hypogastric (7/23, 30%) paravertebral sympathetic plexus were prospectively planned in twelve human cadavers using a 1...
May 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28396932/comparison-of-analgaesia-with-lumbar-epidurals-and-lumbar-plexus-nerve-blocks-in-patients-receiving-multimodal-analgaesics-following-primary-total-hip-arthroplasty-a-retrospective-analysis
#16
N Robert Harvey, Bethany J Wolf, Eric D Bolin, Sylvia H Wilson
PURPOSE: Significant post-operative pain occurs after hip arthroplasty. In a prior study, lumbar plexus nerve blocks provided comparable analgaesia to lumbar epidurals; however, multimodal analgaesics were not used consistently. METHODS: This study assessed a randomly selected cohort of 48 patients undergoing primary hip arthroplasty who received a regional anaesthesia technique for post-operative pain. Twenty-four patients with lumbar epidurals and 24 with single-injection lumbar plexus nerve blocks were reviewed using electronic medical records...
April 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28365495/relationship-of-the-lumbar-plexus-branches-to-the-lumbar-spine-anatomical-study-with-application-to-lateral-approaches
#17
Richard Isaiah Tubbs, Brandon Gabel, Shiveindra Jeyamohan, Marc Moisi, Jens R Chapman, R David Hanscom, Marios Loukas, Rod J Oskouian, Richard Shane Tubbs
BACKGROUND CONTEXT: Injuries to the lumbar plexus during lateral approaches to the spine are not uncommon and may result in permanent deficits. However, the literature contains few studies that provide landmarks for avoiding the branches of the lumbar plexus. PURPOSE: The present anatomical study was performed to elucidate the course of these nerves in relation to lateral approaches to the lumbar spine. STUDY DESIGN: This is a quantitative anatomical cadaveric study...
March 30, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28352485/lateral-lumbar-interbody-fusion-for-ossification-of-the-yellow-ligament-in-the-lumbar-spine-first-reported-case
#18
Kengo Fujii, Tetsuya Abe, Toru Funayama, Hiroshi Noguchi, Keita Nakayama, Kousei Miura, Katsuya Nagashima, Hiroshi Kumagai, Masashi Yamazaki
When ossification of the yellow ligament (OYL) occurs in the lumbar spine and extends to the lateral wall of the spinal canal, facetectomy is required to remove all of the ossified lesion and achieve decompression. Subsequent posterior fixation with interbody fusion will then be necessary to prevent postoperative progression of the ossification and intervertebral instability. The technique of lateral lumbar interbody fusion (LLIF) has recently been introduced. Using this procedure, surgeons can avoid excess blood loss from the extradural venous plexus and detachment of the ossified lesion and the ventral dura mater is avoidable...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28348503/gabapentin-does-not-appear-to-improve-postoperative-pain-and-sleep-patterns-in-patients-who-concomitantly-receive-regional-anesthesia-for-lower-extremity-orthopedic-surgery-a-randomized-control-trial
#19
Jean Daniel Eloy, Christy Anthony, Shawn Amin, Moorice Caparó, Mark C Reilly, Steven Shulman
In recent years, gabapentin has gained popularity as an adjuvant therapy for the treatment of postoperative pain. Numerous studies have shown a decrease in pain score, even with immediate postoperative activity, which is significant for early post-op ambulation and regaining functionality sooner. However, studies have been in conclusive in patients undergoing lower extremity orthopedic surgery. For this reason, we hoped to study the effect of gabapentin on postoperative pain in patients undergoing total knee arthroplasty, total hip arthroplasty, or a hip fracture repair...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28315922/superior-perioperative-analgesia-with-combined-femoral-obturator-sciatic-nerve-block-in-comparison-with-posterior-lumbar-plexus-and-sciatic-nerve-block-for-acl-reconstructive-surgery
#20
Metaxia Bareka, Michael Hantes, Eleni Arnaoutoglou, George Vretzakis
PURPOSE: The purpose of this randomized controlled study is to compare and evaluate the intraoperative and post-operative outcome of PLPS nerve block and that of femoral, obturator and sciatic (FOS) nerve block as a method of anaesthesia, in performing ACL reconstruction. METHODS: Patients referred for elective arthroscopic ACL reconstruction using hamstring autograft were divided in two groups. The first group received combined femoral-obturator-sciatic nerve block (FOS Group) under dual guidance, whereas the second group received posterior lumbar plexus block under neurostimulation and sciatic nerve block (PLPS Group) under dual guidance...
March 18, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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