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Lumbar plexus

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https://www.readbyqxmd.com/read/28806216/psoas-versus-femoral-blocks-a-registry-analysis-of-risks-and-benefits
#1
Hagen Bomberg, Andrea Huth, Stefan Wagenpfeil, Paul Kessler, Hinnerk Wulf, Thomas Standl, André Gottschalk, Jens Döffert, Werner Hering, Jürgen Birnbaum, Claudia Spies, Bernd Kutter, Jörg Winckelmann, Gerald Burgard, Oliver Vicent, Thea Koch, Daniel I Sessler, Thomas Volk, Alexander Raddatz
BACKGROUND AND OBJECTIVES: Psoas blocks are an alternative to femoral nerve blocks and have the potential advantage of blocking the entire lumbar plexus. However, the psoas muscle is located deeply, making psoas blocks more difficult than femoral blocks. In contrast, while femoral blocks are generally easy to perform, the inguinal region is prone to infection. We thus tested the hypothesis that psoas blocks are associated with more insertion-related complications than femoral blocks but have fewer catheter-related infections...
August 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28792797/magnetic-resonance-imaging-and-clinical-findings-associated-with-choroid-plexus-spinal-cord-drop-metastases
#2
Carmen L Yeamans, Rodrigo Gutierrez-Quintana, Allison Haley, Catherine G Lamm
A 5 yr old castrated male whippet presented with a unique presentation of ambulatory paraparesis and subsequent diagnosis of primary intracranial choroid plexus carcinoma, with metastases to the cervical, thoracic, lumbar, and sacral spinal cord segments. Magnetic resonance imaging was performed initially of the thoracolumbar vertebral column and was followed by MRI sequences of the brain for confirmation of the presence of a primary intracranial tumor. The dog was euthanized immediately following diagnostic imaging due to the severity of clinical signs and poor prognosis...
August 9, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28781205/psoas-compartment-and-sacral-plexus-block-via-electrostimulation-for-pelvic-limb-amputation-in-dogs
#3
Jonathon M Congdon, Pedro Boscan, Clara S S Goh, Marlis Rezende
OBJECTIVE: To assess the efficacy of psoas compartment and sacral plexus block for pelvic limb amputation in dogs. STUDY DESIGN: Prospective clinical study. ANIMALS: A total of 16 dogs aged 8±3 years and weighing 35±14 kg (mean±standard deviation). METHODS: Dogs were administered morphine (0.5 mg kg(-1)) and atropine (0.02 mg kg(-1)); anesthesia was induced with propofol and maintained with isoflurane. Regional blocks were performed before surgery in eight dogs with bupivacaine (2...
March 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28763319/compressed-air-injection-technique-for-shamrock-lumbar-plexus-block
#4
Ban C H Tsui
No abstract text is available yet for this article.
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28749094/superiority-of-ultrasound-guided-shamrock-lumbar-plexus-block
#5
Martin V Nielsen, Thomas F Bendtsen, Jens Børglum
BACKGROUND: Ultrasound-guided lumbar plexus block performed with the Shamrock approach has received much interest since the technique was first described in 2013. The technique is believed to be faster and easier to perform and possibly safer in regards to potential complications compared with other lumbar plexus blocks. METHODS: In order to outline some favorable characteristics of the Shamrock lumbar plexus block, we performed an exhaustive search of the current literature; even though it is rather limited...
July 26, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28697031/epidural-injections-contraindicated-for-lumbar-radiculopathy-in-may-thurner-syndrome-a-case-report
#6
Michael Sniderman
A 59-year-old patient presented to the chronic pain clinic with a 6-week history of worsening lumbar back pain, bilateral thigh pain, and unilateral radiculopathy. Magnetic resonance imaging revealed mild discogenic and facetogenic disease, but significant epidural venous plexus engorgement compressing the thecal sac. The patient reported previous treatment by a vascular surgeon for May-Thurner Syndrome, a type of inferior vena caval obstruction, yet had not experienced these specific complaints. A discussion with the radiologist confirmed worsening of the patient's May-Thurner Syndrome was the likely cause of the patient's symptoms...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28668438/lumbar-plexus-in-patients-with-chronic-inflammatory-demyelinating-polyneuropathy-evaluation-with-3d-nerve-sheath-signal-increased-with-inked-rest-tissue-rapid-acquisition-of-relaxation-enhancement-imaging-3d-shinkei
#7
Akio Hiwatashi, Osamu Togao, Koji Yamashita, Kazufumi Kikuchi, Ryotato Kamei, Daichi Momosaka, Hidenori Ogata, Ryo Yamasaki, Masami Yoneyama, Jun-Ichi Kira, Hiroshi Honda
PURPOSE: To evaluate whether 3D SHINKEI in the lumbar plexus could identify patients with chronic inflammatory demyelinating polyneuropathy (CIDP). MATERIALS AND METHODS: Twenty-one patients with CIDP and 15 non-CIDP patients were studied in this retrospective study. The SNR, contrast-to-noise ratio (CNR), contrast ratio (CR) and the size of the lumbar ganglions and roots were measured. Statistical analyses were performed with Mann-Whitney U test and receiver operating characteristics (ROC) analysis...
August 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28658039/radiographic-analysis-of-psoas-morphology-and-its-association-with-neurovascular-structures-at-l4-5-with-reference-to-lateral-approaches
#8
Philip K Louie, Ankur S Narain, Fady Y Hijji, Alem Yacob, Kelly H Yom, Frank M Phillips, Kern Singh
STUDY DESIGN: Retrospective imaging review. OBJECTIVE: Utilize magnetic resonance imaging (MRI) to expand the anatomical description of psoas morphology and its association with neurovascular structures at L4-5. SUMMARY OF BACKGROUND DATA: Anatomical psoas muscle variants may present a greater risk of neurovascular injury at the L4-5 level during lateral transpsoas approaches. METHODS: Axial L4-5 sections of consecutive patients who obtained lumbar MRIs were analyzed...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28651520/surgical-anesthesia-with-a-combination-of-t12-paravertebral-block-and-lumbar-plexus-sacral-plexus-block-for-hip-replacement-in-ankylosing-spondylitis-care-compliant-4-case-reports
#9
Xijian Ke, Ji Li, Yong Liu, Xi Wu, Wei Mei
BACKGROUND: Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. CASE PRESENTATION: Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints...
June 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28619496/injury-to-the-lumbar-plexus-and-its-branches-following-lateral-fusion-procedures-a-cadaver-study
#10
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
#11
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
#12
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
#13
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
#14
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
#15
Yoshinori Maki, Motohiro Takayama, Hideki Hayashi, Yohei Yokoyama, Yuji Agawa
BACKGROUND: Several postoperative complications related to lumbar microdiscectomy 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...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#16
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
#17
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
#18
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
#19
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
#20
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
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