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At least 217 records · Page 12Linked to original sources
PubMed1993

Straight leg raising. Anatomical effects on the spinal nerve root without and with fusion.

Straight leg raising (SLR) is a useful clinical test to demonstrate an inflammatory compressive process across a spinal nerve root. Several previous studies have attempted to evaluate the effect of SLR on nerve root motion, but the exact direction and amount of this motion is still unclear. Components of the SLR test that have not been adequately addressed include the effect of SLR on the intact dural-nerve root system, motion of the nerve tissues as distinct from the dura, and nerve root strain. Separately, spinal fusion is occasionally used as an adjunct to discectomy to decrease instability and subsequent "nerve root irritation." The effect of a one-level fusion on in situ nerve root biomechanics, however, has not been evaluated. Ten fresh human cadavers underwent posterior lumbar laminectomies. Spinal nerve root motion was studied while a SLR maneuver was performed. Data was recorded photographically and statistically analyzed. The results were as follows: 1) SLR induced both linear motion (0.5-5 mm) and strain (2-4%) in spinal nerves L4, L5, and S1; 2) The dura moved less than the intrathecal nerve root at the pedicle and experienced more strain (P < .05). 3) The nerve roots moved laterally toward the pedicle and thus would move into a posterolaterally herniated disc. 4) Rigid anterior stabilization did not decrease nerve root motion or strain.

Aged↗
PubMed1997

Involvement of alpha2-adrenoceptors in mediating sympathetic excitation of injured dorsal root ganglion neurons in rats with spinal nerve ligation.

The present study examined the effects of sympathetic stimulation on the activity of primary afferent neurons that had peripheral axons being injured previously by a spinal nerve ligation. About 22% of afferents with injured fibers that showed spontaneous discharge were excited by sympathetic stimulation or systemic injection of adrenaline. Most sympathetically-excited afferent neurons had axons that conducted in the A-fiber range. This sympathetically-evoked afferent excitation was not affected by cutting the spinal nerve at a place close to the dorsal root ganglion (DRG). Yohimbine, alpha2-antagonist, suppressed sympathetically-evoked afferent excitation which was not affected by alpha1-antagonist prazosin. Clonidine, alpha2-agonist, exerted an excitatory effect, whereas alpha1-agonist phenylephrine had no effect on the activity of afferents with injured fibers. No afferent fibers in control preparations responded to sympathetic stimulation. The results suggest that after a spinal nerve ligation, injured DRG neurons with fast-conducting fibers become sensitive to sympathetic activity via activation of alpha2-adrenoceptors.

Adrenergic alpha-Agonists↗
PubMed1978

[Intracranial neurinoma of the spinal nerve (author's transl)].

A patient aged 56 years has developed a syndrome affecting the last cranial nerves--IX, X, XI and XII--on the left side progressively over the last two years, and, more recently, deafness. Apart from a simple radiological examination all other radiological tests were negative. The diagnosis was made during the surgical operation which revealed a neurinoma of nerve XI (spinal) in its intracranial path. The diagnosis was confirmed histologically. After reviewing the published literature, the authors conclude that this is an exceptional case, which justifies publication and enables differential diagnosis to be made between this tumor and the Jugular Glomus tumor.

Accessory Nerve↗
PubMed2000

Effects of endogenous neurotrophins on sympathetic sprouting in the dorsal root ganglia and allodynia following spinal nerve injury.

Peripheral nerve injury is often complicated by a chronic pain syndrome that is difficult to treat. In animal models of peripheral nerve injury, sympathetic nerve terminals in the dorsal root ganglia (DRG) sprout to form baskets around large diameter neurons, an anatomical change that has been implicated in the induction of neuropathic pain. In the present study, we have investigated whether neurotrophins derived from peripheral sources play any roles in sympathetic sprouting and neuropathic pain in a rat model of peripheral nerve injury. After transection of the left lumbar (L) 5 spinal nerve, antisera specific to neurotrophins were injected intraperitoneally twice a week for 2 weeks. The foot withdrawal response to von Frey hairs was examined on days 1, 3, 7, 10, and 14 postlesion. After completion of behavioral tests, sympathetic sprouting in DRG was examined by tyrosine hydroxylase (TH) immunohistochemistry. The number of TH-immunoreactive (ir) fibers and baskets around large neurons within the lesioned DRG was dramatically increased in the rats treated with control normal sheep serum. Antisera specific to nerve growth factor (NGF), neurotrophin-3 (NT3), and brain-derived neurotrophic factor (BDNF) significantly reduced the sympathetic sprouting and the formation of baskets. L5 spinal nerve lesion induced a significant increase in foot withdrawal responses to von Frey hair stimuli, which was attenuated by treatment of antisera to neurotrophins with a different time sequential. The effect of BDNF antiserum occurred earlier and lasted longer than those of NGF and NT3 antisera. These results implicate that peripherally derived neurotrophins are involved in the induction of sympathetic sprouting and neuropathic pain following peripheral nerve injury.

Animals↗
PubMed2006

Intraoperative monitoring of segmental spinal nerve root function with free-run and electrically-triggered electromyography and spinal cord function with reflexes and F-responses. A position statement by the American Society of Neurophysiological Monitoring.

BACKGROUND CONTEXT: Orthodromic ascending somatosensory evoked potentials and antidromic descending neurogenic somatosensory evoked potentials monitor spinal cord sensory function. Transcranial motor stimulation monitors spinal cord motor function but only activates 4-5% of the motor units innervating a muscle. Therefore, 95-96% of the motor spinal cord systems activating the motor units are not monitored. To provide more comprehensive monitoring, 11 techniques have been developed to monitor motor nerve root and spinal cord motor function. These techniques include: 1. neuromuscular junction monitoring, 2. recording free-run electromyography (EMG) for monitoring segmental spinal nerve root function, 3. electrical stimulation to help determine the correct placement of pedicle screws, 4. electrical impedance testing to help determine the correct placement of pedicle screws, 5. electrical stimulation of motor spinal nerve roots, 6. electrical stimulation to help determine the correct placement of iliosacral screws, 7. recording H-reflexes, 8. recording F-responses, 9. recording the sacral reflex, 10. recording intralimb and interlimb reflexes and 11. recording monosynaptic and polysynaptic reflexes during dorsal root rhizotomy. OBJECTIVE: This paper is the position statement of the American Society of Neurophysiological Monitoring. It is the practice guideline for the intraoperative use of these 11 techniques. METHODS: This statement is based on information presented at scientific meetings, published in the current scientific and clinical literature, and presented in previously-published guidelines and position statements of various clinical societies. RESULTS: These 11 techniques when used in conjunction with somatosensory and transcranial motor evoked potentials provide a multiple-systems approach to spinal cord and nerve root monitoring. CONCLUSIONS: The techniques reviewed in this paper may be helpful to those wishing to incorporate these techniques into their monitoring program.

Electromyography↗
PubMed1984

Scoliosis caused by section of dorsal spinal nerve roots.

Experimental evidence has accumulated in recent years to suggest that scoliosis can be caused by asymmetrical spinal muscle weakness due to sensorineural loss, though this suggestion has not achieved universal acceptance. The evidence is supported by histopathological observations on cases of clinical idiopathic scoliosis. A study is presented in which cynomolgus monkeys had one, two or three dorsal spinal nerve roots cut. Scoliosis developed, convex to the damaged side; its severity was dependent on the number of nerve roots cut. Section of the first lumbar dorsal spinal nerve root had a marked tendency to cause scoliosis. The study supports the view that scoliosis may be caused by asymmetrical paraspinal muscle weakness acting through loss of proprioception.

Animals↗
PubMed1998

Specific targeting of ganglion cell sprouts provides an additional mechanism for restoring peripheral motor circuits in pelvic ganglia after spinal nerve damage.

The pelvic ganglia contain both sympathetic and parasympathetic neurons and provide an interesting model in which to study the effects of a distributed spinal nerve lesion. Previous animal studies have suggested that after either lumbar or sacral nerve injury, some functional connections are restored between preganglionic and postganglionic neurons. It has been proposed that this is because of intact preganglionic axons sprouting collaterals to supply denervated ganglion cells. However, this has never been demonstrated, and our study has investigated whether the ganglion cells themselves contribute to axogenesis and restoration of peripheral circuitry. We have monitored the growth of axons from pelvic ganglion cells after lumbar or sacral nerve injury (partial decentralization), or a combination of the two (total decentralization). These new processes were distinguished from intact preganglionic terminals by their immunoreactivity for substances present only in pelvic ganglion neurons (vasoactive intestinal peptide, neuropeptide Y, and tyrosine hydroxylase). The proportion of pelvic neurons surrounded by these immunostained fibers was then assessed. Complete removal of preganglionic terminals provides the biggest stimulus for growth of new axon processes (sprouts), which grow profusely within just a few days. These arise from each of the main chemical classes of pelvic neurons but grow at different rates and have different distributions. Importantly, some chemical classes of sprouts preferentially supply neurons of dissimilar histochemistry, suggesting the presence of very specific targeting mechanisms rather than random growth. These sprouts are transient, however, those formed after partial decentralization appear to be maintained. Moreover, after lesion of either lumbar or sacral spinal nerves, many sprouts arise from neurons with intact spinal connections and innervate neurons that have lost their preganglionic inputs. This provides a very different alternative mechanism to reestablish communication between preganglionic and postganglionic neurons. In conclusion, we have demonstrated a rapid and selective axogenesis within the pelvic ganglion after spinal nerve injury. This may allow the development of novel strategies by which autonomic nerve pathways can be experimentally manipulated, to facilitate more rapid return of appropriate peripheral reflex control.

Animals↗
PubMed1995

Spinal nerve root compression.

The pathophysiology of sciatica is not completely understood, although our understanding of its causes is increasing. Mechanical alterations combined with inflammatory changes lead to pain. Compression alters nerve root conduction and compromises the nutritional support of spinal nerve roots (through intrinsic and extrinsic vascularity and cerebral spinal fluid percolation). Mechanical forces can lead to intraneural damage and functional changes in nerve roots. Chemical and metabolic effects can create an inflammatory response. Varying causes of inflammation coupled with varying degrees of compression can occur anywhere along the cauda equina or spinal nerve root, including the dorsal root ganglia, and contribute to the pain response and neurologic deficits associated with sciatica.

Animals↗
PubMed1991

Evidence from cadavers suggestive of entrapment of fifth lumbar spinal nerves by lumbosacral ligaments.

Lumbosacral spines from 51 geriatric-age cadavers (25 men and 26 women) were examined both grossly and under the dissecting microscope for evidence of compression of fifth lumbar spinal nerves by their respective lumbosacral ligaments. These ligaments were found to extend from the transverse process and body of L5 to the ala of the sacrum in 97% of the specimens, and from the transverse process and body of L5 to the promontory of the sacrum in 3% of the specimens. Anterior primary rami of the fifth lumbar spinal nerve were observed to be compressed in 11% (11 of 102) of the specimens examined grossly and under the dissecting microscope. Histologic evidence of chronic compression, as suggested by perineurial and endoneurial fibrosis, peripheral thinning of myelin sheaths, or subjective evidence of a shift in fiber diameter to a population of smaller size fibers was found, deep to the lumbosacral ligament, in three of the 11 nerves judged to be compressed. The information derived is of interest to the clinician whose patient presents with L5 root signs and a myelogram, discogram, and computed tomographic scan which do not show any abnormality. The possibility of extraforaminal compression must be considered as a possible source of the clinical signs.

Aged↗
PubMed2004

Primary malignant melanoma of the cervical spinal nerve root.

The authors report on a case of primary malignant melanoma of the 7th cervical spinal nerve root in a 45-year-old woman. Neuro-radiological features of this extra-dural mass were suggestive of a nerve sheath tumor. The lesion underwent total gross resection through the anterolateral approach. The patient's postoperative course was uneventful. Histopathological investigation confirmed malignant melanoma. There was no evidence of tumor recurrence or other melanotic lesions on regular follow-up examinations until the postoperative eighth month. When treating a common, benign-looking lesion of the cervical spinal nerve root, surgeons should be aware of the potential to encounter such a malignant tumor.

Cervical Vertebrae↗
PubMed1983

The organization of the thoracic spinal nerve projection in the rat dorsal horn demonstrated with transganglionic transport of horseradish peroxidase.

Transganglionic transport of horseradish peroxidase (HRP) was used to study the organization of the thoracic spinal nerve projection to the dorsal horn in rats. Labeling was found in the superficial dorsal horn 16-20 hours after application of HRP to the cut ends of various spinal nerve rami. Labeling was restricted to the outer part of the substantia gelatinosa at these stages. Longer survivals (25-48 hours) gave rise to labeling of the deep part of substantia gelatinosa and deeper parts of the dorsal horn as well. The dorsal ramus projected to the lateral third of the horn from half a segment rostral to half a segment caudal to the entry segment. The ventral ramus projected to the medial two-thirds of the horn from 1 1/2 segments rostral to half a segment caudal to the entry segment. The two branches of the ventral ramus that were examined projected to separate medial and lateral compartments for the entire ventral ramus. There was a distinct lateromedial shift of the projection found from rostral through caudal levels within the projection compartment for each nerve. The results indicate that the dorsal horn projection of thoracic spinal nerve branches is organized in longitudinal compartments which are arranged in a strictly somatotopic fashion.

Animals↗
PubMed1991

Spinal cord mensuration--a comparative study on the spinal cord segments and spinal nerves in Zambian goats.

It has been known that the relative length of spinal cord and its segmental volume in domestic animals has established that the dynamics of spinal cord is directly related with the functions of the limbs and in particular to their feeding habits. Bilateral rostrocaudal measurements of spinal nerves involving their root attachment length, root emergence length, interroot length, segment length and cross sectional area were recorded on the dorsal and ventral surfaces of each segment of the spinal cords of five local healthy Zambian goats. We identified that the brachial and lumbar enlargements have involved identical number of spinal cord segments. Brachial and lumbar enlargements extended from C6 to T1 and L4 to L7. The average length of spinal cord was 59.9 cm and it extended up to caudal end of 5th sacral vertebrae. The root emergence length appeared to decrease gradually from C2 segment, which remained less variable in thoracic and lumbar segments and then receded sharply through sacral segments. The dorsal nerves entered spinal cord over a greater area than ventral because of more spinal rootlets. The greatest segment length lied in mid cervical region and then from lumbar segment it decreased sharply up to the end of sacral segments. It is concluded that these goats have a feeding habit similar to that of cattle rather than resting their forelimbs on the shrubs while nibbling the leaves as recorded in Asian goats. It also confirmed that the shrubs were more drooping along with grasses in the Gwembe Valley of Zambia.

Animals↗
PubMed2002

Alteration of dorsal root ganglion P2X3 receptor expression and function following spinal nerve ligation in the rat.

One subtype of ATP-gated ion channel, the P2X(3) receptor, is expressed primarily on peripheral sensory neurons. While it is known that P2X(3) receptors can participate in certain forms of nociceptive signaling, their involvement in neuropathic pain transmission is not known. We have examined the expression and function of P2X(3) receptors in a rat spinal nerve ligation model of neuropathic pain. Fourteen days following L5/L6 spinal nerve ligation, the corresponding dorsal root ganglia (DRG) were removed from animals exhibiting mechanical allodynia, and these were studied using immunohistochemical and electrophysiological techniques. Using a polyclonal antibody to label the P2X(3) receptor, a significant reduction in neuronal P2X(3) immunoreactivity was observed in the ipsilateral (injured) L5 and L6 DRG following nerve ligation. In vitro electrophysiological analysis of acutely isolated DRG neurons revealed a similar decrease in functional P2X(3)-containing receptors. In small diameter (22-25 micro m) neurons, a significant reduction in the number of cells exhibiting a response to alpha,beta-meATP was observed. However, a subset of small diameter neurons retained P2X(3) responses of equal amplitude to those recorded from naive and sham control DRG neurons. Interestingly, P2X(3) immunoreactivity and P2X(3)-like responses were also detected in a subset of larger diameter (50 micro m) neurons and the number and amplitude of these responses were unchanged after spinal nerve ligation. These results suggest that, while there appears to be a decrease in fast desensitizing P2X(3) receptors following L5/L6 nerve ligation injury, certain subsets of small and large DRG neurons maintain normal P2X(3) receptor expression and function. These remaining receptors may provide a P2X(3) receptor-mediated component to neuropathic pain.

Adenosine Triphosphate↗
PubMed2004

Solitary fibrous tumor of the spinal nerve rootlet: report of a case mimicking schwannoma.

We report a case of solitary fibrous tumor involving the spinal nerve root at the L1-L2 level in a 67-year-old man. The patient presented with lumbar pain and weakness in his right lower extremity. Histologically, the tumor was composed of a proliferation of monomorphous spindle cells in an abundant collagenous stroma; neither necrosis nor mitoses were evident. These cells were strongly immunoreactive with CD34, Bcl-2, CD99, and vimentin, but were negative with S100 protein, smooth muscle actin, and epithelial membrane antigen. Such an immunohistochemical profile was consistent with a solitary fibrous tumor of the spinal nerve rootlet and ruled out the main differential diagnoses, schwannoma and meningioma. The present case suggests that solitary fibrous tumor should be considered in differentiating spindle cell lesions of the spinal cord and nerve rootlet.

Aged↗
PubMed2006

Clonidine maintains intrathecal self-administration in rats following spinal nerve ligation.

Clonidine is approved for spinal administration against neuropathic pain, and reverses both spontaneous and elicited pain in humans following spinal administration. Rodent studies that seek to model pharmacology in pain states have historically relied on reflexive withdrawal from noxious stimuli as the primary endpoint. Drug self-administration studies have face validity in the drug abuse field for modeling drug abuse in humans, however, this methodology has not been applied to address issues related to drug seeking behaviors that may be relevant for other human populations, such as patients with neuropathic pain. Rats without spinal nerve ligation (SNL) failed to acquire intrathecal clonidine self-administration over 10 days of access. Rats were found to self-administer intrathecal infusions of clonidine following SNL in a stable and dose-responsive manner, however, and clonidine was self-administered throughout the day with 66% of total drug intake occurring during the dark cycle. Substitution of clonidine with saline or with clonidine and the alpha2-adrenoceptor antagonist idazoxan resulted in extinction of responding in SNL animals. Food reinforcement was initially decreased in SNL rats self-administering clonidine compared to normal animals, however, tolerance developed to this effect of clonidine in SNL rats after 5 days. These data demonstrate that drug self-administration can be applied to questions other than drug abuse, and provides an additional measure for development of novel therapeutic strategies for chronic pain treatment.

Analgesics↗