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Medial branch

Chang Hwa Hong, Young Koo Lee, Sung Hun Won, Dhong Won Lee, Sang Il Moon, Woo Jong Kim
RATIONALE: Tarsal tunnel syndrome (TTS) is a compressive neuropathy of the posterior tibial nerve or one of its branches within the tarsal tunnel that is often caused by a variety of space-occupying lesions, such as ganglia, lipomas, varicosities, neural tumors, trauma, or systemic disease. The os sustentaculi is a small accessory bone, bridged to the posterior aspect of the sustentaculum tali by fibrocartilage. To the best of our knowledge, this is a rare case of successful treatment of TTS caused by the os sustantaculi...
June 2018: Medicine (Baltimore)
Thomas Le Corroller, Elodie Santiago, Arnaud Deniel, Anne Causeret, Pierre Champsaur, Raphaël Guillin
PURPOSE: To determine whether ultrasound allows precise assessment of the course and relations of the medial plantar proper digital nerve (MPPDN). MATERIALS AND METHODS: This work was initially undertaken in six cadaveric specimens and followed by a high-resolution ultrasound study in 17 healthy adult volunteers (34 nerves) by two musculoskeletal radiologists in consensus. Location and course of the MPPDN and its relationship to adjacent anatomical structures were analysed...
June 19, 2018: European Radiology
Ricardo Chmelnitsky Wainberg, Marcos Devanir Silva da Costa, Yair A Ugalde Hernández, Ricardo Lourenço Caramanti, César Augusto Ferreira Alves Filho, Helbert Palmiero, Ricardo Pagung Saick, Feres Chaddad-Neto
The distal posterior inferior cerebellar artery (PICA) is a rare site of aneurysm formation. Only small case series and case reports regarding surgical treatment are found in the literature.The PICA is divided into 5 segments (anterior medullary, lateral medullary, tonsilomedullary, telovelotonsillary, and cortical), and the distal ones represent the most complex, due to anatomic variations. We present a case of a 69-yr-old female patient who has suffered from a sudden and intense occipital headache, associated with nausea and vomiting...
June 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
Johan Hambræus, Hans Westergren
Introduction Patients exposed to whiplash trauma are at risk of developing pain and dysfunction of the neck and shoulder. Although rarely discussed in the literature, some patients also develop autonomic dysfunction. Case presentation A previously healthy 41-year-old woman was involved in a "head-on" car crash. During the following 3 years she developed severe and complex post-traumatic pain syndrome, which consisted of neck pain, lumbar pain, sensory-motor dysfunction, and myoclonic muscular contractions...
December 29, 2017: Scandinavian Journal of Pain
Leif Måwe, Lena Thorén, Jan Persson
Aims To evaluate the effect of spinal interventions following ISIS guidelines [1]. Methods Data from all patients from April 2012 until February 2014 have been registered and followed up after 4-6 months. Patients were mainly referred from surgeons at the regional hospitals. Employment status, medication, VAS, EQ-5D-5L, EQ-VAS and pain reduction were gathered before and at the follow-up. Only patients receiving any kind of treatment were included. Results So far 419/823 patients have been followed-up. Here we present levels of medication and total pain reduction for all patients and, separately, for patients treated with radio frequency facet joint medial branch neurotomy (n = 76)...
December 29, 2017: Scandinavian Journal of Pain
Peter J Ciolek, Brandon L Prendes, Michael A Fritz
INTRODUCTION: The reconstructive goals following radical parotidectomy include restoration of symmetry, reanimation of the face, and reestablishment of oral competence. We present our experience utilizing the anterolateral thigh (ALT) free flap, orthodromic temporalis tendon transfer (OTTT), and facial nerve cable grafting to reestablish form and function. MATERIAL AND METHODS: From 2010 to 2016, 17 patients underwent radical parotidectomy followed by immediate reconstruction...
June 7, 2018: American Journal of Otolaryngology
Yabo Huang, Zhong Wang, Qingdong Han
RATIONALE: Tumor resection and extracranial-intracranial bypass concerning medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery (ICA) of intracranial segments has been rarely presented. Effective treatment as to the complex lesions may be complicated. Tumor resection and cerebrovascular protection should be both taken into consideration. PATIENT CONCERNS: We presented one case of medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery of intracranial segments...
June 2018: Medicine (Baltimore)
O Varela, A Melone, R López-Menchaca, R Sevilla, D Callejo, S López-Álvarez, A Román Fernández, S García, I Mantilla, M Zaballos
OBJECTIVE: Interfascial blocks of the thoracic wall are being developed as an alternative to central blocks in breast surgery. However, there are few studies that have evaluated the anatomical extension of the local anaesthetic. The objective of this study was to analyse, using fluoroscopy, the spreading of two volumes (10 vs. 20ml) of radiological contrast in the serratus-intercostal plane block in an experimental pig model. MATERIAL AND METHODS: Ten Large-White breed pigs were selected to have a bilateral ultrasound serratus-intercostal plane block performed, with the administering of 10ml and 20ml of iopamidol in the right and left hemithorax, respectively...
June 7, 2018: Revista Española de Anestesiología y Reanimación
Corine L Creech, Priscilla Zinyemba, Eric T Choi, Andrew J Meyr
The transmetatarsal amputation is considered a durable procedure with respect to limb salvage when managing the consequences of diabetic foot disease. The success of the procedure is, in part, determined by the preoperative appreciation of arterial and functional status. The objectives of the present investigation were to determine the length of the remaining first metatarsal required during transmetatarsal amputation to preserve the anastomotic connection of the deep plantar perforating artery and subsequent "vascular arch" of the foot and the insertion of the tibialis anterior tendon...
June 4, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Erik N K Cressman, Chunxiao Guo
PURPOSE: Embolotherapies are commonly used for management of primary liver cancer. Explant studies of treated livers, however, reveal an untreated tumor in a high fraction of cases. To improve on this, we propose a new concept referred to as thermoembolization. In this technique, the embolic material reacts in local tissues. Highly localized heat energy is released simultaneously with the generation of acid in the target vascular bed. Combined with ischemia, this should provide a multiplexed attack...
June 5, 2018: Cardiovascular and Interventional Radiology
David S Stolzenberg, Ryan Pheifer, Joshua Armstrong, George Young, Jeffrey Gehret, Jeremy Simon, George C Chang-Chien
BACKGROUND: Neural blockade of the cervical medial branches is a validated procedure in the diagnosis and treatment of cervical zygapophyseal joint pain. Fluoroscopic visualization of the lower cervical medial branch target zones (CMBTZs) in lateral view is sometimes challenging or not possible due to the patient's shoulders obscuring the target. Large shoulders and short necks often exacerbate the problem. Clear visualization is critical to accuracy and safety. OBJECTIVE: We aim to describe a method for optimal fluoroscopic visualization of the lower CMBTZs using a modified swimmer's view...
May 2018: Pain Physician
Tim Hahn, Marc-Eric Halatsch, Christian Wirtz, Stephan Klessinger
BACKGROUND: Among the various causes of vertigo, the so-called cervicogenic vertigo (CV) has been the most controversial. However, perturbations of proprioceptive signals and abnormal activity of the cervical afferents can induce vertigo. Medial branch blocks (MBBs) are a diagnostic tool designed to test whether a patient's neck pain is mediated by one or more of the medial branches of the dorsal rami of the spinal nerve. It is unknown whether MBBs are also suitable for testing symptoms other than pain...
May 2018: Pain Physician
Edoardo Dalla Pozza, Bahar Bassiri Gharb, Francis A Papay, Richard L Drake, Andrew Steckler, Antonio Rampazzo
BACKGROUND: Hand transplantation in patients with severe upper extremity burns can be associated with an increased risk of exposure of vessels, tendons and nerves because of extensive skin and soft tissue deficit. This study evaluated how to reliably transfer additional extended skin flaps with a standard hand allograft. METHODS: Twenty-five upper extremities were used. Sixteen were injected with latex to map the perforating branches of the brachial (BA), superior ulnar collateral (SUCA), radial (RA), ulnar (UA) and posterior interosseous (PIA) arteries...
May 19, 2018: Plastic and Reconstructive Surgery
Albert J Fenoy, Paul E Schulz, Sudhakar Selvaraj, Christina L Burrows, Giovanna Zunta-Soares, Kathryn Durkin, Paolo Zanotti-Fregonara, Joao Quevedo, Jair C Soares
Deep brain stimulation (DBS) to the superolateral branch of the medial forebrain bundle (MFB) has been reported to lead to rapid antidepressant effects. In this longitudinal study, we expand upon the initial results we reported at 26 weeks (Fenoy et al., 2016), showing sustained antidepressant effects of MFB DBS on six patients with treatment-resistant depression (TRD) over 1 year. The Montgomery-Åsberg Depression Rating Scale (MADRS) was used as the primary assessment tool. Deterministic fiber tracking was used to individually map the target area; analysis was performed to compare modulated fiber tracts between patients...
June 4, 2018: Translational Psychiatry
Steven P Cohen, Tina L Doshi, Octav C Constantinescu, Zirong Zhao, Connie Kurihara, Thomas M Larkin, Scott R Griffith, Michael B Jacobs, William J Kroski, Timothy C Dawson, Ian M Fowler, Ronald L White, Aubrey J Verdun, David E Jamison, Mirinda Anderson-White, Stephanie E Shank, Paul F Pasquina
BACKGROUND: With facet interventions under scrutiny, the authors' objectives were to determine the effectiveness of different lumbar facet blocks and their ability to predict radiofrequency ablation outcomes. METHODS: A total of 229 participants were randomized in a 2:2:1 ratio to receive intraarticular facet injections with bupivacaine and steroid, medial branch blocks, or saline. Those with a positive 1-month outcome (a 2-point or more reduction in average pain score) and score higher than 3 (positive satisfaction) on a 5-point satisfaction scale were followed up to 6 months...
May 30, 2018: Anesthesiology
Cristina Russo, Antonella Russo, Rosalia Pellitteri, Stefania Stanzani
Ghrelin, a gastrointestinal hormone, is a modulator of the sense of smell. The main source of ghrelin in the central nervous system has been mainly observed in specific populations of hypothalamic neurons. An increasing number of studies have reported ghrelin synthesis and its effect on neurons outside the hypothalamus. Ghrelin and its receptors are expressed in the olfactory bulbs and in other centres of the brain, such as the amygdala, for processing olfactory signals, pyramidal neurons of the cerebral cortex and the dorsal vagal complex of the medulla oblongata...
May 29, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Volker Arnd Coenen, Lena Valerie Schumacher, Christoph Kaller, Thomas Eduard Schlaepfer, Peter Christoph Reinacher, Karl Egger, Horst Urbach, Marco Reisert
Introduction: Despite their importance in reward, motivation, and learning there is only sparse anatomical knowledge about the human medial forebrain bundle (MFB) and the connectivity of the ventral tegmental area (VTA). A thorough anatomical and microstructural description of the reward related PFC/OFC regions and their connection to the VTA - the superolateral branch of the MFB (slMFB) - is however mandatory to enable an interpretation of distinct therapeutic effects from different interventional treatment modalities in neuropsychiatric disorders (DBS, TMS etc...
2018: NeuroImage: Clinical
Yi Yuan, Tao Wang, Jun Yuan, Gangbo Qu, Pandeng Hao, Zhijiang Zeng, Bing Luo, Jiafu Yang
Objective: To evaluate the feasibility and effectiveness of percutaneous cannulated screw fixation for the treatment of Day type Ⅱ pelvic crescent fracture. Methods: The clinical data of 14 patients with Day type Ⅱ pelvic crescent fractures underwent closed reduction and percutaneous cannulated screw fixation between January 2009 and July 2016 were retrospectively analysed. There were 9 males and 5 females, aged 17-65 years (mean, 38 years). The causes of injury included traffic accident in 8 cases, falling from height in 3 cases, bruise injury in 3 cases; all were closed fractures...
February 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Meng-Zhao Deng, Yi-Han Liu, Aaron Huang, Zi-Jun Liu
PURPOSE: To investigate how tongue volume reduction affects loads on surrounding bone surfaces produced by neuromuscular stimulation of the tongue. MATERIALS AND METHODS: Of each pair of same-gender minipig siblings, 1 received tongue reduction and 1 underwent sham surgery. Either immediately (acute, 6 pairs) or 1 month (chronic, 5 pairs) after surgery, bone surface and/or suture strains and pressures were recorded from the following locations when the hypoglossal nerve trunk, hypoglossal nerve medial branch, hypoglossal nerve lateral branch, genioglossus, and styloglossus (SG) were electrically stimulated: 1) three rosette strain gauges on the premaxillary palatal surface (premaxilla [PM]) and lingual surfaces of the mandibular alveolus at anterior (mandibular incisor [MI]) and posterior (mandibular molar [MM]) locations; 2) two single-element strain gauges over the palatal surface of the premaxillary-maxillary suture and the lingual surface of the mandibular symphysis; and 3) two pressure transducers on the palatal surface of the maxilla (palatal process) and the lingual surface of the mandibular alveolus (mandibular corpus)...
May 1, 2018: Journal of Oral and Maxillofacial Surgery
R S Camenzind, K Stoffel, N J Lash, M Beck
SURGICAL PRINCIPLE AND OBJECTIVE: The direct anterior approach for total hip arthroplasty is associated with higher complication rates and difficult femoral component positioning. Performing a modified technique in the lateral position allows secure component positioning. INDICATIONS: Primary hip replacement (including femoral neck fracture) and cup revision without bone deficiency. CONTRAINDICATIONS: Destruction/deformities of proximal femur or acetabulum, bone deficiency or malignancy...
May 25, 2018: Operative Orthopädie und Traumatologie
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