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Lumbar plexus

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https://www.readbyqxmd.com/read/29756695/stimulating-versus-non-stimulating-catheter-for-lumbar-plexus-continuous-infusion-after-total-hip-replacement
#1
Gianluca Cappelleri, Daniela Ghisi, Andrea L Ambrosoli, Alice Ascari, Elisa Compagnino, Marco Gemma, Giorgio Danelli
BACKGROUND: This study was aimed to investigate whether stimulating catheters for continuous lumbar plexus block reduce local anesthetic consumption after hip arthroplasty if compared with traditional non-stimulating catheters. METHODS: Seventy-two ASA I-III, 18-82 year-old, undergoing primary hip replacement (THA) for osteoarthritis with spinal anesthesia were randomized into two groups: Stim group (stimulating catheter, n=36) and Nonstim group (non-stimulating catheter, n=36)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29707550/complications-on-minimally-invasive-oblique-lumbar-interbody-fusion-at-l2-l5-levels-a-review-of-the-literature-and-surgical-strategies
#2
REVIEW
Javier Quillo-Olvera, Guang-Xun Lin, Hyun-Jin Jo, Jin-Sung Kim
Fusion is the cornerstone in the treatment of an unstable degenerative lumbar spinal disease. Various techniques have been developed. Amongst these techniques exists the oblique lumbar interbody fusion (OLIF), which is the ante-psoas approach. Adequate restoration of disc height with large cages placed in the intervertebral space, indirect decompression, and correction of sagittal and coronal alignment can be achieved with OLIF procedure with the advantage of minimal risk for the psoas muscle and lumbar plexus...
March 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29575220/lumbosacral-plexus-root-thickening-establishing-normal-root-dimensions-using-magnetic-resonance-neurography
#3
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/29552093/high-resolution-nerve-ultrasound-and-magnetic-resonance-neurography-as-complementary-neuroimaging-tools-for-chronic-inflammatory-demyelinating-polyneuropathy
#4
Kalliopi Pitarokoili, Moritz Kronlage, Philip Bäumer, Daniel Schwarz, Ralf Gold, Martin Bendszus, Min-Suk Yoon
Background: We present a clinical, electrophysiological, sonographical and magnetic resonance neurography (MRN) study examining the complementary role of two neuroimaging methods of the peripheral nervous system for patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Furthermore, we explore the significance of cross-sectional area (CSA) increase through correlations with MRN markers of nerve integrity. Methods: A total of 108 nerve segments on the median, ulnar, radial, tibial and fibular nerve, as well as the lumbar and cervical plexus of 18 CIDP patients were examined with high-resonance nerve ultrasound (HRUS) and MRN additionally to the nerve conduction studies...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29536189/posterior-resection-of-fifth-lumbar-giant-schwannoma-combined-with-a-recapping-transiliac-approach-case-report-and-technical-note
#5
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/29528455/lumbar-sympathetic-plexus-block-as-a-treatment-for-postamputation-pain-methodology-for-a-randomized-controlled-trial
#6
Zachary L McCormick, Andrew Hendrix, David Dayanim, Bryan Clay, Amy Kirsling, Norman Harden
Objective: We present a technical protocol for rigorous assessment of patient-reported outcomes and psychophysical testing relevant to lumbar sympathetic blocks for the treatment of postamputation pain (PAP). This description is intended to inform future prospective investigation. Design: Series of four participants from a blinded randomized sham-controlled trial. Setting: Tertiary, urban, academic pain medicine center. Subjects: Four participants with a single lower limb amputation and associated chronic PAP...
March 8, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29516348/three-dimensional-visualization-of-internal-vertebral-venous-plexuses-relative-to-dural-sac-and-spinal-nerve-root-of-spinal-canal-stenosis-using-mri
#7
Junji Kamogawa, Osamu Kato, Tatsunori Morizane
PURPOSE: The aim of this study was to introduce a new method of producing three-dimensional (3D) images of vertebral venous plexuses (VVPs) by 3D-MRI with and without contrast media, to identify pathoanatomical features that might accelerate or modify spinal canal stenosis. METHODS: We used a 1.5-T MRI unit with two different 3D sequences with and without contrast media. Multi planar reconstruction (MPR) images of VVPs could be obtained by volume image subtraction methods with a workstation for dural sac from whole 3D volume MPR without contrast media, using images before and after gadoteridol injection...
May 2018: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29507018/acute-demyelinating-neuropathy-in-a-patient-with-neurolymphomatosis
#8
Rola A Mahmoud, Charles K Abrams
Peripheral neurological complications of lymphomas are rare and much less frequent than central complications. Nonetheless, on occasion, systemic non-Hodgkin's lymphoma may directly infiltrate the peripheral nervous system at various levels. This report describes a man with non-Hodgkin's lymphoma and leptomeningeal disease who developed progressive areflexic quadraparesis. Initial electromyography (EMG) was consistent with a polyradiculopathy and a repeat EMG performed 1 month later for worsening symptoms showed evidence of demyelination...
March 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29505853/use-of-motor-evoked-potentials-during-lateral-lumbar-interbody-fusion-reduces-postoperative-deficits
#9
Michael R Riley, Adam T Doan, Richard W Vogel, Alexander O Aguirre, Kayla S Pieri, Edward H Scheid
BACKGROUND CONTEXT: Intraoperative neurophysiological monitoring (IONM) has gained rather widespread acceptance as a method to mitigate risk to the lumbar plexus during lateral lumbar interbody fusion (LLIF) surgery. The most common approach to IONM involves using only electromyography (EMG) monitoring, and the rate of postoperative deficit remains unacceptably high. Other test modalities, such as transcranial electric motor-evoked potentials (tcMEPs) and somatosensory-evoked potentials, may be more suitable for monitoring neural integrity, but they have not been widely adopted during LLIF...
April 3, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29503679/psoas-morphology-differs-between-supine-and-sitting-magnetic-resonance-imaging-lumbar-spine-implications-for-lateral-lumbar-interbody-fusion
#10
Aaron J Buckland, Bryan M Beaubrun, Evan Isaacs, John Moon, Peter Zhou, Sam Horn, Gregory Poorman, Jared C Tishelman, Louis M Day, Thomas J Errico, Peter G Passias, Themistocles Protopsaltis
Study Design: Retrospective radiological review. Purpose: To quantify the effect of sitting vs supine lumbar spine magnetic resonance imaging (MRI) and change in anterior displacement of the psoas muscle from L1-L2 to L4-L5 discs. Overview of Literature: Controversy exists in determining patient suitability for lateral lumbar interbody fusion (LLIF) based on psoas morphology. The effect of posture on psoas morphology has not previously been studied; however, lumbar MRI may be performed in sitting or supine positions...
February 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/29492826/treatment-of-complex-regional-pain-syndrome-an-updated-systematic-review-and-narrative-synthesis
#11
Silvia Duong, Daniela Bravo, Keith J Todd, Roderick J Finlayson, De Q Tran
PURPOSE: Although multiple treatments have been advocated for complex regional pain syndrome (CRPS), the levels of supportive evidence are variable and sometimes limited. The purpose of this updated review is to provide a critical analysis of the evidence pertaining to the treatment of CRPS derived from recent randomized-controlled trials (RCTs). SOURCE: The MEDLINE, EMBASE, Psychinfo, and CINAHL databases were searched to identify relevant RCTs conducted on human subjects and published in English between 1 May 2009 and 24 August 2017...
February 28, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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
#12
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/29491335/-cerebrospinal-fluid-leakage-and-abducens-nerve-palsy-caused-by-bowling-activity
#13
Hiroyasu Inoue, Masaya Takemoto, Masahiro Muto, Taro Kitamura, Kentaro Yamada
Cerebrospinal fluid leakage can develop due to traffic trauma or lumbar puncture; however, in many cases, it develops spontaneously without any obvious cause. This report describes a case of cerebrospinal fluid leakage caused by bowling activity. A 57-year-old woman adjusted her bowling form, which led to the development of an orthostatic headache and double vision. Cerebrospinal fluid leakage and right abducens nerve palsy was diagnosed, which was resistant to conservative treatment. An epidural blood patch was performed, leading to an improvement in the headache and abducens nerve palsy...
March 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
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/29415912/idiopathic-and-chronic-epidural-hematoma-in-the-lumbar-spine-a-case-report-and-review-of-literatures
#15
Toshiyuki Okazaki, Hiroshi Nakagawa, Hitoshi Hayase, Shinsuke Irie, Toru Inagaki, Osamu Saito, Motoshige Yamashina, Shinji Nagahiro, Koji Saito
Spontaneous and chronic epidural hematoma (SSEH) in the lumbar spine is rare, and idiopathic and chronic SSEH in the lumbar spine is extremely rare disease. Most of lumbar SSEH were acute and secondary with trauma, hematologic disorders, drug, and surgical procedure. Only 20 cases of chronic SSEH in the lumbar spine have been reported and 14 cases among them were considered to be idiopathic. Definitive guidelines for management of this condition are not clear and surgical total evacuation was performed in most of the cases...
March 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29415656/comparison-of-lumbar-plexus-block-using-the-short-axis-in-plane-method-at-the-plane-of-the-transverse-process-and-at-the-articular-process-a-randomized-controlled-trial
#16
Rui Lu, Chengcheng Shen, Chunyong Yang, Yan Chen, Juanjuan Li, Kaizhi Lu
BACKGROUND: Although the safety and effectiveness of the short-axis in-plane method has been confirmed for lumbar plexus block, the operation is difficult and has a high rate of epidural spread at the plane of the articular process. Therefore, we developed a new in-plane technique, called the beach chair method, which displays images from the transverse process. We compared the operative difficulty and incidence of epidural spread of the beach chair method with those of the control method (at the plane of the articular process) in this randomized controlled clinical trial...
February 7, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29372027/lumbar-burner-and-stinger-syndrome-in-an-elderly-athlete
#17
Veronika Wegener, Axel Stäbler, Volkmar Jansson, Christof Birkenmaier, Bernd Wegener
Burner or stinger syndrome is a rare sports injury caused by direct or indirect trauma during high-speed or contact sports mainly in young athletes. It affects peripheral nerves, plexus trunks or spinal nerve roots, causing paralysis, paresthesia and pain. We report the case of a 57-year-old male athlete suffering from burner syndrome related to a lumbar nerve root. He presented with prolonged pain and partial paralysis of the right leg after a skewed landing during the long jump. He was initially misdiagnosed since the first magnet resonance imaging was normal whereas electromyography showed denervation...
January 2018: Korean Journal of Pain
https://www.readbyqxmd.com/read/29359366/ultrasound-guided-lumbar-plexus-block-in-children-and-adolescents-using-a-transverse-lumbar-paravertebral-sonogram-initial-experience
#18
Karen Boretsky, Maria A Hernandez, Elizabeth Eastburn, Cornelius Sullivan
BACKGROUND: The clinical reliability and reproducibility of ultrasound-guided lumbar plexus blocks is not established in pediatric populations. We present the results of a combined nerve stimulation ultrasound-guided lumbar plexus block using the vertebral body, transverse process, and psoas muscle as landmarks on a transverse lumbar paravertebral sonogram with mid-axillary transducer placement, "shamrock method," in children and adolescents. AIMS: Our primary objective was to determine the rate of achieving sensory changes in the lumbar plexus distribution...
March 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29352055/concomitant-conus-medullaris-arteriovenous-shunts-and-sacral-dural-arteriovenous-fistulas-pathophysiological-links-related-to-the-venous-drainage-of-the-lesions-in-a-series-of-five-cases
#19
Andrea Rosi, Arturo Consoli, Stéphanie Condette-Auliac, Oguzhan Coskun, Federico Di Maria, Georges Rodesch
BACKGROUND: Spinal cord arteriovenous shunts (scAVSs) are a group of lesions located in the spinal cord itself or in the surrounding structures. The most common scAVSs are spinal dural arteriovenous fistulas (sDAVFs), which are acquired lesions. The pathogenesis of sDAVFs involves thrombosis and venous hypertension as trigger factors. Intradural scAVSs such as spinal cord arteriovenous nidus type malformations (AVMs) and pial arteriovenous fistulas are less common than sDAVFs and are considered to have a so-called 'congenital' origin...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29351647/minimally-invasive-lateral-retroperitoneal-approach-for-resection-of-extraforaminal-lumbar-plexus-schwannomas-operative-techniques-and-literature-review
#20
Michael M Safaee, Christopher P Ames, Vedat Deviren, Aaron J Clark
BACKGROUND: Traditional approaches for retroperitoneal lumbar plexus schwannomas involve anterior open or laparoscopic resection. For select tumors, the lateral retroperitoneal approach provides a minimally invasive alternative. OBJECTIVE: To describe a minimally invasive lateral transpsoas approach for the resection of retroperitoneal schwannomas. METHODS: A lateral retroperitoneal transpsoas approach was used to resect a 3.1 × 2.7 × 4...
January 17, 2018: Operative Neurosurgery (Hagerstown, Md.)
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