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Lumbar plexus

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https://www.readbyqxmd.com/read/27903340/-the-clinical-application-of-lumbar-plexus-the-first-posterior-sacral-foramina-block-for-hip-arthroplasty-in-elderly-patients
#1
J Li, X J Ke, Y Liu, K Chen, M B Chen, W Mei
Objective: To evaluate the clinical efficacy of lumbar plexus-the first posterior sacral foramina block as an anesthesia technique for hip arthroplasty in elderly patients. Methods: Forty-four patients, aged 60-91 years, weighing 37-100 kg, American Society of Anesthesiologists (ASA) Ⅰ-Ⅲ, underwent elective hip arthroplasty in Tongji Hospital from February 2015 to January 2016.All patients received lumbar plexus and the first posterior sacral foramina block.The first posterior sacral foramina puncture point of 23 cases were located by traditional positioning method, the others were orientated via ultrasonic method...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27891579/unexpected-motor-weakness-following-quadratus-lumborum-block-for-gynaecological-laparoscopy
#2
M Wikner
Quadratus lumborum block has recently been described as an effective and long-lasting analgesic strategy for various abdominal operations, including gynaecological laparoscopy. Despite evidence that the analgesic effect is mediated by indirect paravertebral block and that local anaesthetic spreads to the lumbar paravertebral space, there have been no reports to date of lower limb motor weakness. We present a patient with unilateral hip flexion and knee extension weakness leading to unplanned overnight admission following lateral quadratus lumborum block with 20 ml levobupivacaine 0...
November 28, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27875415/a-posterior-oblique-approach-to-the-lumbar-disk-spaces-vertebral-bodies-and-lumbar-plexus-a-cadaveric-feasibility-study
#3
Alexander Spiessberger, Fabian Baumann, Martin Häusler, Frank Rühli, Javier Fandino, Carl Muroi
STUDY DESIGN: A laboratory cadaveric study. OBJECTIVE: We aimed to demonstrate the feasibility of a posterior oblique approach, sharing the same advantages as the transpsoas technique while minimizing the risk of lumbar plexus or psoas muscle injuries. SUMMARY OF BACKGROUND DATA: The transpsoas approach for interbody fusion and corpectomy offers advantages over posterior and anterior approaches. However, possible risks include traumatization of the psoas muscle or lumbar plexus...
November 21, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#4
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27843688/extreme-lateral-lumbar-interbody-fusion-do-the-cons-outweigh-the-pros
#5
Nancy E Epstein
BACKGROUND: Major factors prompted the development of minimally invasive (MIS) extreme lateral interbody fusion (XLIF; NuVasive Inc., San Diego, CA, USE) for the thoracic/lumbar spine. These include providing interbody stabilization and indirect neural decompression while avoiding major visceral/vessel injury as seen with anterior lumbar interbody fusion (ALIF), and to avert trauma to paraspinal muscles/facet joints found with transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion (PLIF), and posterior-lateral fusion techniques (PLF)...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27843679/high-neurological-complication-rates-for-extreme-lateral-lumbar-interbody-fusion-and-related-techniques-a-review-of-safety-concerns
#6
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/27813034/-horner-syndrome-following-combined-spinal-epidural-anesthesia
#7
Ömer Karaca, Sezen Kumaş Solak, Serdar Demirgan, Mehmet Bademci
Horner syndrome is rarely observed in connection with epidural anesthesia. It is characterized by ptosis, enophthalmos, miosis, anisocoria, and conjunctival hyperemia in the affected eye, as well as anhydrosis and flushing on the affected side of the face. It is usually a complication spontaneously resolved without permanent neurological deficits. Intraoral anesthesia; stellate ganglion, cervical or brachial plexus blocks; thoracic, lumbar or caudal epidural anesthesia, and intrapleural analgesia are the main causes for Horner syndrome related to anesthesia...
July 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/27752405/the-epidural-ligaments-of-hofmann-a-comprehensive-review-of-the-literature
#8
Gabrielle G Tardieu, Christian Fisahn, Marios Loukas, Marc Moisi, Jens Chapman, Rod J Oskouian, R Shane Tubbs
The epidural space contains the internal vertebral venous plexus, adipose, and other connective tissues. In the anatomical literature, there are nonspecific descriptions of varying fibrous connective tissue bands in the epidural space, mainly mentioned in the lumbar region, that tether the dural sac to the posterior longitudinal ligament, the vertebral canal, and the ligamentum flavum. These ligaments have been termed as Hofmann's ligaments. This review expands on the anatomy and function of Hofmann's ligaments, increasing the awareness of their presence and serves as an impetus for further study of their histology, innervation, and function...
September 13, 2016: Curēus
https://www.readbyqxmd.com/read/27746549/attitudes-awareness-and-barriers-regarding-evidence-based-orthopedic-surgery-between-health-professionals-from-a-brazilian-public-health-system-sus-hospital-study-of-400-patients
#9
Luiz Eduardo Imbelloni, Geraldo Borges de Morais Filho
BACKGROUND: The fast-track concept refers to all phases of perioperative care: Preoperative, intraoperative, and postoperative strategies. Although most research has focused on adherence to medication, adherence also encompasses numerous health-related behaviors. The aim of this prospective study was to determine the attitudes and awareness among health professionals involved in the treatment of elderly patients with fractures of the femur and the results of 400 patients. METHODS: The postoperative protocol acceleration was presented to various hospital departments through four seminars...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27730633/a-radiologic-and-anatomic-assessment-of-injectate-spread-following-transmuscular-quadratus-lumborum-block-in-cadavers
#10
S D Adhikary, K El-Boghdadly, Z Nasralah, N Sarwani, A M Nixon, K J Chin
We performed bilateral transmuscular quadratus lumborum blocks in six cadavers using iodinated contrast and methylene blue. Computed tomography imaging was performed in four cadavers and anatomical dissection was completed in five. This demonstrated spread to the lumbar paravertebral space in 63% of specimens, laterally to the transversus abdominis muscle in 50% and caudally to the anterior superior iliac spine in 63% of specimens. There was no radiographic evidence of spread to the thoracic paravertebral space...
October 12, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27721757/a-case-of-suspected-breast-cancer-metastasis-to-brachial-plexus-detected-by-magnetic-resonance-neurography
#11
Atsushi Mizuma, Chikage Kijima, Eiichiro Nagata, Shunya Takizawa
Metastasis of breast cancer is often detected through a long-term course and difficult to diagnose. We report a case of brachial plexopathy suspected to be the initial lesion of breast cancer metastasis, which was only detected by magnetic resonance (MR) neurography. A 61-year-old woman was admitted to our hospital within 2 years after operation for breast cancer because of progressive dysesthesia and motor weakness initially in the upper limb on the affected side and subsequently on the contralateral side...
May 2016: Case Reports in Oncology
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
#12
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...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27695532/role-of-endoscopic-third-ventriculostomy-in-tuberculous-meningitis-with-hydrocephalus
#13
Yad R Yadav, Vijay S Parihar, Mina Todorov, Yatin Kher, Ishwar D Chaurasia, Sonjjay Pande, Hemant Namdev
Hydrocephalus is one of the commonest complications of tuberculous meningitis (TBM). It can be purely obstructive, purely communicating, or due to combinations of obstruction in addition to defective absorption of cerebrospinal fluid (CSF). Endoscopic third ventriculostomy (ETV) as an alternative to shunt procedures is an established treatment for obstructive hydrocephalus in TBM. ETV in TBM hydrocephalus can be technically very difficult, especially in acute stage of disease due to inflamed, thick, and opaque third ventricle floor...
October 2016: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/27683674/lumbar-interbody-fusion-techniques-indications-and-comparison-of-interbody-fusion-options-including-plif-tlif-mi-tlif-olif-atp-llif-and-alif
#14
REVIEW
Ralph J Mobbs, Kevin Phan, Greg Malham, Kevin Seex, Prashanth J Rao
Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF)...
December 2015: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27672677/left-paraaortic-inframesenteric-lymphadenectomy-preserving-the-superior-hypogastric-plexus-supported-by-indocyanine-green-icg-labeling-of-the-lymphatic-compartment-in-cervical-cancer
#15
Rainer Kimmig, Peter Rusch, Paul Buderath, Bahriye Aktas
Superior hypogastric plexus (SHG) contains mainly sympathetic and most probably also postganglionic parasympathetic fibers. Thus, surgical damage of SHG may cause autonomic pelvic organ dysfunction (Kraima et al., 2015). As already shown for rectal cancer, preservation of the autonomic nerves is facilitated by robotic surgery and may avoid sexual dysfunctions and voiding disorders (Kim et al., 2015). In this educational video, we demonstrate left lower paraaortic lymph node dissection preserving the SHG using ICG fluorescence to label the lymphatic compartment...
November 2016: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/27671080/viral-neurotropism-peripheral-neuropathy-and-other-morphological-abnormalities-in-bovine-ephemeral-fever-virus-infected-downer-cattle
#16
R Barigye, S Davis, R Hunt, N Hunt, S Walsh, N Elliott, C Burnup, S Aumann, C Day, K Dyrting, R Weir, L F Melville
OBJECTIVE: This study assessed the neurotropism of bovine ephemeral fever (BEF) virus (BEFV) and described histomorphological abnormalities of the brain, spinal cord and peripheral nerves that may causally contribute to paresis or paralysis in BEF. METHODS: Four paralysed and six asymptomatic but virus-infected cattle were monitored, and blood and serum samples screened by qRT-PCR, virus isolation and neutralisation tests. Fresh brain, spinal cord, peripheral nerve and other tissues were qRT-PCR-tested for viral RNA, while formalin-fixed specimens were processed routinely and immunohistochemically evaluated for histomorphological abnormalities and viral antigen distribution, respectively...
October 2016: Australian Veterinary Journal
https://www.readbyqxmd.com/read/27666420/evaluation-of-the-sacral-nerve-plexus-in-pelvic-endometriosis-by-three-dimensional-mr-neurography
#17
Xiaoling Zhang, Meizhi Li, Jian Guan, Huanjun Wang, Shurong Li, Yan Guo, Mingjuan Liu
PURPOSE: To investigate the feasibility of three-dimensional MR neurography (3D MRN) for the sacral plexus using sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences, and to demonstrate structural abnormalities in the pelvic nerve of women with pelvic endometriosis. MATERIALS AND METHODS: Twenty patients with pelvic endometriosis and 20 healthy controls were examined by contrast-enhanced 3D short time inversion recovery T2-weighted imaging (CE 3D STIR T2WI) SPACE sequences on 3 Tesla MRI...
September 26, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27617106/progressive-foot-drop-caused-by-below-knee-compression-stocking-after-spinal-surgery
#18
Karan Malhotra, Joseph S Butler, Adam Benton, Sean Molloy
Foot drop is a debilitating condition, which may take many months to recover. The most common cause of foot drop is a neuropathy of the common peroneal nerve (CPN). However, similar symptoms can be caused by proximal lesions of the sciatic nerve, lumbar plexus or L5 nerve root. We present a rare and unusual case of a patient undergoing spinal surgery at the level of L5/S1 and presenting 4 weeks postoperatively with progressive foot drop. Although the initial concern was a postoperative lesion at L5, the cause for this delayed presentation was extrinsic compression of the CPN at the level of the fibular head by a tight-fitting below-knee thromboembolic deterrent stocking...
September 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27616276/role-of-transient-receptor-potential-melastatin-2-trpm2-channels-in-visceral-nociception-and-hypersensitivity
#19
Kenjiro Matsumoto, Kanako Takagi, Atsumi Kato, Takuya Ishibashi, Yasuo Mori, Kimihito Tashima, Atsushi Mitsumoto, Shinichi Kato, Syunji Horie
Transient receptor potential melastatin 2 (TRPM2) is a thermosensitive, Ca(2+)-permeable cation channel. TRPM2 contributes to the pathogenesis of inflammatory bowel disease, and inflammatory and neuropathic pain. We hypothesized that TRPM2 is important for visceral nociception and the development of visceral hypersensitivity. Therefore, we investigated the expression of TRPM2 channels and their involvement in visceral nociception in normal physiology and under pathological conditions that cause visceral hypersensitivity in rats...
November 2016: Experimental Neurology
https://www.readbyqxmd.com/read/27597428/comparison-of-lumbar-epidurals-and-lumbar-plexus-nerve-blocks-for-analgesia-following-primary-total-hip-arthroplasty-a-retrospective-analysis
#20
Sylvia H Wilson, Bethany J Wolf, Abdalrahman A Algendy, Clark Sealy, Harry A Demos, Julie R McSwain
BACKGROUND: Total hip arthroplasty (THA) is associated with significant postoperative pain. Both lumbar epidurals and lumbar plexus nerve blocks have been described for postoperative pain control, but it is unclear if one technique is more beneficial. METHODS: Using electronic medical records, a randomly selected, cohort of 58 patients with lumbar epidurals were compared with 58 patients with lumbar plexus nerve blocks following primary THA. The primary end point was 48-hour postoperative opiate consumption...
August 10, 2016: Journal of Arthroplasty
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