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Melissa R Andrews, Sara Soleman, Menghon Cheah, David A Tumbarello, Matthew R J Mason, Elizabeth Moloney, Joost Verhaagen, Jean-Charles Bensadoun, Bernard Schneider, Patrick Aebischer, James W Fawcett
The regenerative ability of CNS axons decreases with age, however, this ability remains largely intact in PNS axons throughout adulthood. These differences are likely to correspond with age-related silencing of proteins necessary for axon growth and elongation. In previous studies, it has been shown that reintroduction of the α9 integrin subunit (tenascin-C receptor, α9) that is downregulated in adult CNS can improve neurite outgrowth and sensory axon regeneration after a dorsal rhizotomy or a dorsal column crush spinal cord lesion...
July 2016: ENeuro
Patrick W Hitchon, Marshall Holland, Jennifer Noeller, Mark C Smith, Toshio Moritani, Nivedita Jerath, Wenzhuan He
OBJECTIVE: For patients with medically unresponsive trigeminal neuralgia (TN), surgical options include microvascular decompression (MVD), radiofrequency rhizotomy (RF), and stereotactic radiosurgery (SRS). In an attempt to identify the risks and benefits and cost inherent with each of the three modalities, we performed a retrospective review of our experience with 195 cases of TN treated over the past 15 years. METHODS: Since 2001, 195 patients with previously untreated TN were managed: with MVD in 79, RF in 36, and SRS in 80...
October 2016: Clinical Neurology and Neurosurgery
James Bales, Susan Apkon, Marisa Osorio, Gregory Kinney, R Aaron Robison, Erin Hooper, Samuel Browd
BACKGROUND/AIMS: Selective dorsal rhizotomy for spastic cerebral palsy is an effective and well-validated surgical approach. Multiple techniques have been described in the past including multiple laminectomies and a single-level laminectomy at the level of the conus. There is considerable technical challenge involved with a single-level laminectomy approach. METHODS: We report here a modification of the single-level laminectomy that selectively analyzes each individual nerve root with electromyography to separate dorsal and ventral nerve roots through comparison of stimulus responses...
2016: Pediatric Neurosurgery
EungDon Kim, MiSun Roh, SooHyang Kim, DaeHyun Jo
The sympathetic block is widely used for treating neuropathic pain such as complex regional pain syndrome (CRPS). However, single sympathetic block often provides only short-term effect. Moreover, frequent procedures for sympathetic block may increase the risk of complications. The use of epidural route may be limited by concern of infection in case of previous implantation of the spinal cord stimulation (SCS). In contrast, a continuous sympathetic block can be administered without such concerns. The continuous thoracic sympathetic block (TSGB) has been used to treat the ischemic disease and other neuropathic conditions such as postherpetic neuralgia...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
M Reid Gooch, Julie G Pilitsis
No abstract text is available yet for this article.
September 2016: Neurosurgery
C Rory Goodwin, Benjamin Northcutt, Daniel Seeburg, Jaehoon Shin, Debebe Theodros, Nancy A Abu-Bonsrah, Daniel Herzka, Nafi Aygun, Ari M Blitz, Michael Lim
INTRODUCTION: Patients with trigeminal neuralgia often undergo glycerol or radiofrequency-thermocoagulation glycerol rhizotomy of the trigeminal nerve for treatment of symptoms. To date, radiological changes in patients with trigeminal neuralgia postrhizotomy have not been described. The aim of this study was to evaluate patients after trigeminal rhizotomy to characterize postrhizotomy changes on 3D high-resolution MRI. METHODS: A retrospective review of trigeminal neuralgia protocol studies was performed on 26 postrhizotomy patients compared with 54 treatment-naive trigeminal neuralgia subjects...
August 2016: Neurosurgery
B G Northcutt, D P Seeburg, J Shin, N Aygun, D A Herzka, D Theodros, C R Goodwin, C Bettegowda, M Lim, A M Blitz
BACKGROUND AND PURPOSE: Patients with trigeminal neuralgia often undergo trigeminal rhizotomy via radiofrequency thermocoagulation or glycerol injection for treatment of symptoms. To date, radiologic changes in patients with trigeminal neuralgia post-rhizotomy have not been described, to our knowledge. The aim of this study was to evaluate patients after trigeminal rhizotomy to characterize post-rhizotomy changes on 3D high-resolution MR imaging. MATERIALS AND METHODS: A retrospective review of trigeminal neuralgia protocol studies was performed in 26 patients after rhizotomy compared with 54 treatment-na|fkve subjects with trigeminal neuralgia...
June 30, 2016: AJNR. American Journal of Neuroradiology
Matthew T Bender, Chetan Bettegowda
Three major percutaneous procedures are currently used to treat trigeminal neuralgia (TN). Percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation interrupt afferent pain fibers by injury to the trigeminal nerve root or ganglion. Each is capable of offering immediate and durable pain relief. Each is associated with relatively low, but variable rates of complications. Patient heterogeneity, technical variation, and nonstandard outcomes plague the existing outcomes literature and limit comparisons of treatments...
July 2016: Neurosurgery Clinics of North America
Smruti K Patel, James K Liu
Although the symptoms associated with trigeminal neuralgia have been well documented, the root cause of this disease initially eluded most surgeons. Although early remedies were haphazard because of a lack of understanding about the condition, near the 20th century both medical and procedural therapies were established for the treatment of trigeminal neuralgia. These treatments include a variety of medications, chemoneurolysis, radiofrequency lesioning, percutaneous ablative procedures, stereotactic radiosurgery, and open rhizotomy and microvascular decompression...
July 2016: Neurosurgery Clinics of North America
Julia Sharma, Christopher Bonfield, Paul Steinbok
PURPOSE: The aim of this study was to determine the outcomes for children who underwent selective dorsal rhizotomy (SDR) for the treatment of spasticity related to spinal pathology. METHODS: We performed a retrospective review of all cases of SDR at our institution over the last 30 years and identified patients in whom spasticity was attributed to spinal rather than cerebral pathology. We gathered demographic information and recorded functional status and spasticity scores pre-operatively and over long-term follow-up...
August 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
M R Golab, P J Breedon, M Vloeberghs
PURPOSE: This research examines an approach for enhancing the efficiency of spinal surgery utilising the technological capabilities and design functionalities of wearable headsets, in this case Google Glass. The aim was to improve the efficiency of the selective dorsal rhizotomy neurosurgical procedure initially through the use of Glass via an innovative approach to information design for an intraoperative monitoring display. METHODS: Utilising primary and secondary research methods the development of a new electromyography response display for a wearable headset was undertaken...
June 9, 2016: European Spine Journal
Walid A Abdel Ghany, Mohamed Nada, Mahmoud A Mahran, Ahmed Aboud, Moustafa G Mahran, Marwa A A Nasef, Mohamed Gaber, Tamer Sabry, Mohamed H Ibrahim, Mohamed H Taha
BACKGROUND: Children with cerebral palsy (CP) can present with severe secondary dystonia with or without associated spasticity of their extremities. OBJECTIVE: To assess the outcomes of combined anterior and posterior lumbar rhizotomy for the treatment of mixed hypertonia in the lower extremities of children with CP. METHODS: Fifty children with CP were subjected to combined anterior and posterior lumbar rhizotomies in a prospective study...
September 2016: Neurosurgery
Laura R Grootveld, Petra E M van Schie, Annemieke I Buizer, R Jeroen Vermeulen, Willem J R van Ouwerkerk, Rob L M Strijers, Jules J G Becher
Selective dorsal rhizotomy (SDR) surgery is a well-established treatment for ambulatory children with bilateral spastic paresis and is performed to eliminate spasticity and improve walking. The objective of this case report is to describe sudden falls as a persistent complication of SDR. The authors report on 3 patients with bilateral spastic paresis, aged 12, 6, and 7 years at the time of surgery. The percentage of transected dorsal rootlets was around 40% at the L2-S1 levels. Sudden falls were reported with a frequency of several a day, continuing for years after SDR...
August 2016: Journal of Neurosurgery. Pediatrics
Michael H Schwartz, Adam Rozumalski, Katherine M Steele
AIM: To estimate the impact of dynamic motor control on treatment outcomes in children with cerebral palsy. METHOD: We used multiple regression on a retrospective cohort of 473 ambulatory children with cerebral palsy who underwent conservative treatment, single-level orthopaedic surgery, single-event multi-level orthopaedic surgery, or selective dorsal rhizotomy. Outcomes included gait pattern, gait speed, energy cost of walking, and the Pediatric Outcomes Data Collection Instrument...
April 21, 2016: Developmental Medicine and Child Neurology
Devin M Barry, Hui Li, Xian-Yu Liu, Kai-Feng Shen, Xue-Ting Liu, Zhen-Yu Wu, Admire Munanairi, Xiao-Jun Chen, Jun Yin, Yan-Gang Sun, Yun-Qing Li, Zhou-Feng Chen
There are substantial disagreements about the expression of gastrin-releasing peptide (GRP) in sensory neurons and whether GRP antibody cross-reacts with substance P (SP). These concerns necessitate a critical revaluation of GRP expression using additional approaches. Here, we show that a widely used GRP antibody specifically recognizes GRP but not SP. In the spinal cord of mice lacking SP (Tac1KO), the expression of not only GRP but also other peptides, notably neuropeptide Y (NPY), is significantly diminished...
2016: Molecular Pain
Il Choi, Sang Ryong Jeon
Occipital neuralgia is defined by the International Headache Society as paroxysmal shooting or stabbing pain in the dermatomes of the greater or lesser occipital nerve. Various treatment methods exist, from medical treatment to open surgical procedures. Local injection with corticosteroid can improve symptoms, though generally only temporarily. More invasive procedures can be considered for cases that do not respond adequately to medical therapies or repeated injections. Radiofrequency lesioning of the greater occipital nerve can relieve symptoms, but there is a tendency for the pain to recur during follow-up...
April 2016: Journal of Korean Medical Science
Franziska Rumberg, Mustafa Sinan Bakir, William R Taylor, Hannes Haberl, Akosua Sarpong, Ilya Sharankou, Susanne Lebek, Julia F Funk
AIM: Cerebral palsy (CP) is associated with dysfunction of the upper motor neuron and results in balance problems and asymmetry during locomotion. Selective dorsal rhizotomy (SDR) is a surgical procedure that results in reduced afferent neuromotor signals from the lower extremities with the aim of improving gait. Its influence on balance and symmetry has not been assessed. The aim of this prospective cohort study was to evaluate the impact of SDR on balance and symmetry during walking...
2016: PloS One
Hidetaka Arishima, Satoshi Kawajiri, Hiroshi Arai, Yoshifumi Higashino, Toshiaki Kodera, Ken-Ichiro Kikuta
Percutaneous treatments for trigeminal neuralgia (TN) including glycerol rhizotomy (GR), radiofrequency thermocoagulation (RT), and balloon compression (BC) are effective for patients with medical comorbidities and risk factors of microvascular decompression (MVD). These procedures are usually performed under fluoroscopy. Surgeons advance the needle to the trigeminal plexus through the foramen ovale while observing landmarks of fluoroscopic images; however, it is sometimes difficult to appropriately place the needle tip in Meckel's cave...
May 15, 2016: Neurologia Medico-chirurgica
N K Mazarakis, M H Vloeberghs
PURPOSE: Selective dorsal rhizotomy (SDR) is a surgical technique used to treat spasticity in children secondary to cerebral palsy (CP). METHOD: We report, to the best of our knowledge for the first time, the case of a child who underwent SDR for the management of spasticity secondary to Leigh syndrome. RESULT: SDR resulted in excellent functional outcome with significant improvement in spasticity. This result contributes to the mounting evidence that SDR could be used to alleviate spasticity secondary not only to CP but also to other pathologies as well...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Jorge F Ramirez Leon, Jose G Rugeles Ortiz, Enrique Osorio Fonseca, Carolina Ramirez Martinez, Gabriel Oswaldo Alonso Cuellar
BACKGROUND: Zygapophysial joint arthrosis is a pathology related with axial lumbar pain. The most accepted treatment, after failure of medical management, is the thermal denervation of the medial branch. Nonetheless, the placement of the heat probe remains a challenge to surgeons, even when using the fluoroscope. Using a variation of Shealy's and Bogduk's original techniques, which includes ablation of the medial branch and the nerves present in the joint capsule, we hypothesize that we can obtain similar outcomes to those found in the literature...
March 2016: Pain Physician
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