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PubMed1985

Cutaneous receptive fields of somatic and viscerosomatic neurones in the thoracic spinal cord of the cat.

Extracellular single-unit recordings were made from 121 neurones in the thoracic spinal cord of the cat. All neurones could be driven by electrical stimulation of dorsal root afferent fibres. The neurones were classified, according to the absence or presence of inputs from the ipsilateral splanchnic nerve, as "somatic" or "viscerosomatic", respectively. Cutaneous receptive fields were identified for 75 of the neurones: 31 were somatic and 44 viscerosomatic. Only two of the somatic cells received cutaneous nociceptive inputs, compared with 33 of the viscerosomatic cells. Sixty-four percent of the whole sample of neurones had receptive fields which included three or more dermatomes. Viscerosomatic cells tended to have larger receptive fields than the somatic neurones, and six of them had fields which did not include the corresponding (T11) dermatome. Neurones with receptive fields in the dorsal one-third of the dermatome tended to be located in the lateral one-third of the dorsal horn, but those with receptive fields in the ventral two-thirds of the dermatome showed no differential distribution within the gray matter. This is discussed with respect to the results of anatomical studies on the dorsal horn projections of cutaneous afferent fibres from different regions of the dermatome. Preliminary results from intracellular staining with horseradish peroxidase reveal extensive branching of primary afferents in the dorsal horn, and large dendritic fields of dorsal horn neurones. Our physiological and morphological results indicate that the somatotopic organisation of the thoracic spinal cord is less well defined than that of the lumbosacral region.

Animals↗
PubMed1994

Ligand specificity of nicotinic acetylcholine receptors in rat spinal cord: studies with nicotine and cytisine.

Administration of nicotinic agonists to the spinal cord leads to a variety of cardiovascular and behavioral responses. The discrete localization of afferent and efferent fibers presents a system in which occupation of nicotinic receptor subtypes might be correlated with specific pharmacologic responses. To this end, we examined [3H]cytisine and [3H]nicotine binding to membranes isolated from regions of the rat spinal cord. [3H]Cytisine showed saturable, noncooperative (nH congruent to 1) binding to a single-class of sites with a Kd of 0.44 +/- 0.01 nM and total saturable sites of 19.9 +/- 0.9 fmol/mg of protein. [3H]Cytisine binding to membranes from intermediolateral cell column and dorsal and ventral sections of the lumbosacral regions each revealed a single class of binding sites with virtually identical Kd values. However, the dorsal sections of the lumbar spinal cord contained a higher number of total binding sites than ventral lumbar or intermediolateral sections. The rank order potencies of the nicotinic agonists competing for [3H]cytisine binding was cytisine > I-nicotine > N-methylcarbamylcholine > dimethylphenylpiperazinium > acetylcholine > d-nicotine > carbamylcholine. Competitive antagonists also competed with high affinities (Ki as low as nanomolar) with the order of potencies being alpha-lobeline > or = dihydro-beta-erythroidine >> methyllycaconitine, whereas the channel blockers, mecamylamine and hexamethonium, only competed at concentrations > or = 100 microM. Competitive ganglionic blockers such as d-tubocurarine or trimethaphan and neurotoxins such as alpha-bungarotoxin, alpha-cobratoxin or neuronal bungarotoxin had weak affinities for cytisine sites. Similar to [3H]cytisine, [3H]nicotine also revealed a saturable single class of binding sites, but of lower affinity. The rank order of Ki values of the agonists, antagonists and neurotoxins for competing with [3H]nicotine binding was similar to the order for [3H]cytisine. Nicotinic receptors in the spinal cord membrane show a specificity for both agonists and antagonists that differ from neuronal receptors in the ganglia or the regions of the brain characterized to date. These findings, when correlated with the pharmacological responses documented in the comparison article suggests that the spinal nicotinic receptors may define a new member of the neuronal nicotinic receptor family.

Alkaloids↗
PubMed2006

Congenital lumbosacral limb duplication: a case report.

We report a case of congenital lumbosacral limb duplication at the pelvis, lower limb, and foot of a 4-year-old boy. The patient presented with a supernumerary lower limb joined at the lumbosacral region by a bony connection. A pseudo-navel and a pseudo-penis were found on the supernumerary limb and foot duplication was noted at the end. Radiography and a 3-dimensional computed-tomography reconstruction revealed duplication of an inversely oriented pelvis dorsal to the normal pelvis, semi-vertebrae in T7 to T9, thoracolumbar scoliosis, lumbosacral vertebral dysplasia, and dislocation of the left hip. Magnetic resonance imaging demonstrated a tethered spinal cord and an adipoma in the sacral canal. Motor conduction velocity was reduced in the left peroneal nerve. Surgery to remove the supernumerary limb was successfully performed. The patient recovered well and further surgery is planned for functional reconstruction of the left lower limb.

Abnormalities, Multiple↗
PubMed1989

Magnetic stimulation in the diagnosis of lumbosacral radiculopathy.

Five patients presenting with sensory-motor disturbances consistent with a clinical diagnosis of L5 or S1 radiculopathy were studied. All had conventional nerve conduction tests and electromyography. The lumbosacral roots were stimulated in the lumbosacral region by using the Cadwell MES-10 Magneto-electric stimulator. The compound muscle action potentials were recorded bilaterally by surface electrodes applied to the soleus and tibialis anterior muscles. The latencies to the affected muscles were significantly prolonged. The appropriate root dysfunction was confirmed at operation or by the imaging techniques. It was concluded that surface stimulation of the lumbosacral roots by a magnetic coil is a potentially useful technique for the non-invasive evaluation of the function of the lumbosacral roots.

Aged↗
PubMed1986

MRI in infants and children with spinal dysraphism.

Magnetic resonance imaging (MRI) of the spine was used in 37 infants and children to assess the potential of this new technology to evaluate suspected lumbosacral dysraphic myelodysplasia. Eighteen of these patients had correlative metrizamide myelotomography and metrizamide computed tomography (CT). MRI using a spin-echo pulse sequence with short repetition times (TR) and echo delay times (TE) affords optimal delineation of normal and abnormal spinal cord morphology in the lumbosacral region. Coronal projections usually provide an adequate demonstration of the normal conus medullaris for screening purposes; however, multiplanar acquisitions are necessary for more complete delineation of the dysraphic myelopathy. The sensitivity of MRI compares favorably with metrizamide tomography and CT, although these procedures provide somewhat better specificity. These results suggest that MRI is a reliable, noninvasive procedure to screen patients for lumbosacral dysraphism.

Adolescent↗
PubMed1976

Functional characteristics of the intraspinal spread of viscerosomatic activity.

The functional characteristics of the intraspinal spread of the dual-component viscerosomatic reflex response were studied in chloralose-anaesthetized cats. In the region of the direct inputs of splanchnic afferents into the spinal cord, the initial part of the early (propriospinal) component is evoked by afflux from the extraspinal pathway in the sympathetic chain and has the shortest latent period. At segment Th8 to Th12 level this was 5.2--8.1 msec; cranially and caudally from this level it was longer. Activity spreading from the adjacent segments via intraspinal longitudinal systems also participates in the origin and course of the early component of the efferent discharge. The rate of ascending intraspinal irradiation in the thoracic region was 3.2--12 m/sec (6.6 +/- 2.4 m/sec). The rate of the descending spread of propriospinal activity in the thoracic region via intraspinal pathways was 3.6--18.3 m/sec (12.5 +/- 4.5 m/sec); in the lumbar region it was significantly lower -- 2.9--19.3 m/sec (7 +/- 4.5 m/sec). The latent period of the later component varied from 20 to 30 msec and displayed a cranio-caudal increase in length. The rate of the descending spread of the later component in the thoracic and lumbar cord did not differ significantly (20 +/- 10 m/sec and 22 +/- 13 m/sec respectively). The continuous splanchnic discharge in the lumbosacral region is correlated to the different rate of the intraspinal spread of the early and the late response and to their overlapping.

Animals↗
PubMed1993

[The split notochord syndrome. A report of 2 cases].

Split notochord syndrome has been described in several previous case reports; however, we recently treated two patients with a previous undescribed variant of this syndrome. A 2,800 g male baby was admitted to the neonatal patients room with a non covered mass on the lumbo-sacral region, and a portion of intestine, with meconium being passed attached to it the legs were equine-varus and the anus was absent. Radiographs were consistent with a double spine defect (lumbar and sacral split notochord), and the patient was taken to the operating room for closure. A 2,600 g male baby was first seen in other hospital, and was admitted with a circular defect in the mid-line of the lumbosacral region. This defect was conformed by knee, leg, ankle and fingers. Radiographs showed bony structures consistent with incomplete lower extremity. During surgery, the skin overlying the mass was excised, showing a wide spine defect including stomach, duodenum, jejunum, ileum and colon, covered by a peritoneal membrane; there was not communication between this structure and the normal digestive tract.

Abnormalities, Multiple↗
PubMed1992

Congenital absence of lumbosacral articular process: report of three cases.

Defective anomaly of the articular process of the lumbosacral region in three young women is reported. One had a bilateral defect at the lower facet of L1 with defect at L5 right lower and S1 right upper facets. Another had bilateral defects at L5 lower facets, and the third had a defect at the left lower facet of L5 with other anomalies of the lamina. Based on classification of 37 anomalies including those previously reported in the literature, it is concluded that unilateral defect at the lumbosacral apophyseal joint involving both upper and lower facets is the most common anomaly. The pathogenesis of all anomalies is apparently complex. The intervertebral instability caused by these defects may provoke occasional low-back pain, especially in younger persons with a unilateral L5/S1 anomaly.

Adolescent↗
PubMed1995

Traumatic lumbosacral dislocation in a 5-year-old boy with eight years follow-up.

STUDY DESIGN: The authors present an unusual case of pure traumatic bilateral lumbosacral dislocation in a 5-year-old boy, the conservative treatment carried out, and the long-term result. OBJECTIVES: To describe a rare traumatic lesion in children and evaluate the result obtained with conservative treatment. SUMMARY OF BACKGROUND DATA: Watson-Jones was the first to describe this type of lesion. Since then, only a few cases have been added. Most authors suggest that open reduction should be carried out. No cases of this type of injury in children have been reported. METHODS: A 5-year-old boy was hit in the lumbosacral region with a rocking chair. Examination showed neurologic deficit of left L5 and S1 nerve roots. Roentgenographic examination and computed tomography scan confirmed the anterior dislocation of the fifth lumbar vertebra on the sacrum without any fracture. He was treated with traction, followed by hyperextension in a Cotrel traction table and further immobilization with a lumbar plaster jacket. RESULTS: Eight years after the injury, the patient had no neurologic deficit and lumbar radiographs showed a good alignment of the lumbosacral spine. CONCLUSION: In children with traumatic lumbosacral dislocation, closed reduction should be attempted even if neurologic deficit is present.

Child, Preschool↗
PubMed1989

Spinal ganglia reduction in the splotch-delayed mouse neural tube defect mutant.

Splotch and splotch-delayed mutants have anomalies in certain neural crest cell derivatives as well as neural tube defects. A genetic marker was used to identify mutant, heterozygote, and wild-type embryos within a litter, which enabled us to make intergenotypic comparisons. Histological studies of the lumbosacral region of day 15 and day 16 embryos indicated that the splotch-delayed mutant had similar but less severe defects in spinal ganglion development than those reported for splotch (Auerbach: Journal of Experimental Zoology 127:305-329, 1954). The ganglia were extensively reduced in size, residual, or missing in the splotch-delayed mutant, whereas in the splotch mutant, they were virtually nonexistent. Paired comparison analyses showed that all mutant embryos had a significant reduction in their volume of lumbosacral spinal ganglia when compared to their heterozygous and/or wild-type littermates. Also, some heterozygotes were found to have spinal ganglia volumes that were significantly reduced when compared to wild-type embryos. The volume of spinal ganglia was not related to the severity of the neural tube defect. In fact, three mutant embryos, which did not exhibit a neural tube defect, had spinal ganglia volumes comparable to or less than those mutants with open neural tube lesions or curly tails. This shows that the formation of abnormal neural crest cell derivatives is not a result of the neural tube closure defect. We hypothesize that the two anomalies observed in these mutants have a common etiological basis.

Animals↗
PubMed2001

Functional magnetic stimulation of the colon in persons with spinal cord injury.

OBJECTIVE: To evaluate the usefulness of functional magnetic stimulation (FMS) as a noninvasive method to stimulate the colon in individuals with spinal cord injury (SCI). DESIGN: A prospective before-after trial consisting of 2 protocols. SETTING: FMS laboratories of 2 SCI centers. PARTICIPANTS: Two able-bodied men and 13 men with SCI levels ranging from C3 to L1. Protocol 1 consisted of 9 subjects, 2 of whom were excluded from the analysis. Protocol 2 consisted of 4 subjects. INTERVENTION: Commercially available magnetic stimulators with round magnetic coils (MCs) were used. Protocol 1 measured the effects of FMS on rectal pressure by placing the MC on the transabdominal and lumbosacral regions. Protocol 2 consisted of a 5-week stimulation period to investigate the effects of FMS on total and segmental colonic transit times (CTTs). MAIN OUTCOME MEASURE: An increase in rectal pressure and a decrease in CTT by magnetic stimulation. RESULTS: Data were averaged and the standard error of the mean was calculated. Statistically significant changes in rectal pressure and CTT were also measured. Rectal pressures increased from 26.7 +/- 7.44cmH(2)O to 48.0 +/- 9.91cmH(2)O, p =.0037, with lumbosacral stimulation, and from 30.0 +/- 6.35cmH(2)O to 42.7 +/- 7.95cmH(2)O, p =.0015, with transabdominal stimulation. With FMS, the mean CTT decreased from 105.2 to 89.4 hours, p =.02. CONCLUSION: FMS is able to stimulate the colon and reduce CTT. FMS is a noninvasive, technological advancement for managing neurogenic bowel in patients with SCI.

Adult↗
PubMed2002

Single dermatome analgesia sparing in an obstetric patient following previous radiation to that region.

We present a case of an obstetric patient with prior radiation therapy for Hodgkins lymphoma to the right hip, right flank region and lumbar spine, who suffered persistent right sided L1 dermatone distribution sensory and analgesia sparing after routine epidural placement despite additional boluses of local anesthetic. We postulate that the previous radiation therapy received by our patient left sufficient epidural fibrosis as a barrier to prevent spread of local anesthetic to cover the L1 dermatome. Subsequent replacement, using a combined spinal-epidural technique at a higher lumbar space, overcame this obstruction. In patients who have received substantial radiation therapy to the lumbosacral region in the past, awareness of this potential problem may assist in clinical management.

Journal Article↗
PubMedDate not supplied

[Degenerative changes of the lumbosacral transition after Risser and Harrington spondylodesis].

INTRODUCTION: The long-term results of two operation techniques according to Risser and Harrington were of special interest. As part of this study, secondary changes of the lumbar spine, as well as the lumbosacral junction, were evaluated over time. MATERIAL AND METHODS: Two groups of 20 patients, who underwent one of the above-mentioned operative procedures for idiopathic scoliosis were analyzed (group A: Risser procedure, average age 15 years; group B: Harrington procedure, 17 years of age). The preoperative deformity ranged between 34 degrees and 108 degrees Cobb angle. The patients were evaluated at three different points in time: 1) preoperatively; 2) upon the conclusion of outpatient treatment following the surgery; and 3) between 13 and 15 years postoperatively. RESULTS: Degenerative changes, especially spondylarthrosis of the lumbosacral region, were seen more frequently in the Harrington group due to the higher rigidity of the implant and the ensuing increased loading of the adjacent spinal segments. The comparison of the two procedures revealed that a better primary correction of the deformity was achieved with the Harrington operation. Moreover, the Risser group showed a higher rate of pseudarthrosis and secondary loss of correction. In the Harrington group we found a higher rate of degenerative arthritis. CLINICAL RELEVANCE: A better primary correction of the scoliosis leads to a higher strain of the lumbosacral junction. The resultant secondary changes (spondylarthrosis) in this period of observation were rarely of clinical relevance. Nevertheless, whenever possible presacral segments should remain free in the range of a spondylodesis to reduce the loading of the lumbosacral junction.

Adolescent↗
PubMed1989

Variability in soman toxicity in the rat: correlation with biochemical and behavioral measures.

The inhibition of cholinesterase (ChE) activity in the central nervous system of the rat by the potent organophosphorus compound soman was examined. At soman doses greater than 55 micrograms/kg s.c. (0.5 LD50), there were: (1) dose-related inhibition of ChE activity in brain regions; (2) variability in the degree of ChE inhibition at each soman dose in each brain region; and (3) variability in the severity of signs of intoxication at each dose. These data suggest that measurements of ChE should be made directly or predicted individually in each animal for which the effects of soman are assessed. At the estimated ED50 soman dose for signs of intoxication (66 micrograms/kg s.c.), the remaining ChE activity in brain correlated poorly with ChE activity in plasma and red blood cells (R = 0.14-0.20), moderately with behavioral scores based on overt signs of intoxication (R = 0.63-0.94), and well with spinal cord ChE activity (R = 0.93-0.98). Finally, ChE activity in the thoracic and lumbosacral regions of spinal cord were not affected by headfocused microwave inactivation of brain enzymes, demonstrating that ChE activity in these regions of the cord can be used to predict the level of ChE inhibition in brain when direct measurement in brain is unfeasible.

Animals↗
PubMed1999

Peripheral specification of Ia synaptic input to motoneurons innervating foreign target muscles.

Muscle sensory neurons, called Ia afferents, make monosynaptic connections with functionally related sets of motoneurons in the spinal cord. Previous work has suggested that peripheral target muscles play a major role in determining the central connections of Ia afferents with motoneurons. Here, we ask whether motoneurons can also be influenced by their target muscles in terms of the monosynaptic input they receive from Ia afferents, by transplanting thoracic motoneurons into the lumbosacral spinal cord so that they innervate foreign muscles. Three or four segments of thoracic neural tube from stage 14-15 chicken embryos were transplanted to the lumbosacral region of stage 16-17 embryos, and electrophysiological recordings were made from transplanted motoneurons after the embryos had reached stage 38-40. Transplanted thoracic motoneurons innervated limb muscles and received monosynaptic inputs from Ia afferents. These connections were not random: Most of the connections were formed between Ia afferents and motoneurons projecting to the same muscle (homonymous connections). Few aberrant connections were found although the anatomical distribution of afferents in the transplant indicated that they had ample opportunity to contact inappropriate motoneurons. We conclude that although peripheral target cues are not sufficient to respecify an already committed motoneuron (turn a thoracic motoneuron into a lumbosacral motoneuron), they do provide sufficient information for Ia afferent input to be functionally correct.

Afferent Pathways↗
PubMed1997

Disc protrusion in the child. Particular features and comparison with neoplasms.

Lumbar intervertebral disc herniation, although common in adults, is infrequent in the young, and especially in patients under 17 years old. In this work we review clinical data pertaining to two pediatric groups of patients whose main complaint was low back pain and/or sciatica, trying to identify factors that might contribute to their earlier referral and to the differential diagnosis of protruded disc and spinal neoplasm in this population. Group A comprises 17 youngsters diagnosed as having lumbar herniated nucleus pulposus and group B, 16 children with neoplasms of the lower thoracic and lumbosacral regions. Both groups were similar in sex distribution and symptoms of pain and numbness. However, there was a striking difference in age at presentation. No patient in group A was younger than 11 years, while most of those in group B were in their first decade of life (P = 0.018). The classic clinical onset in the children with herniated discs started with low back pain and sciatica, as in the children with neoplasms, although in subgroup B leg pain tended to be bilateral. The usual examination findings in both groups were spinal rigidity and sensory loss, but motor weakness and impaired reflexes were found to be more frequent in the group with spinal growths (P = 0.02). Children with lumbosacral neoplasms also tended to present with atypical symptoms (acute onset, intracranial hypertension, subarachnoid hemorrhage and abdominal pain), while this was the exception in the group with herniated discs. Plain radiographs of the pediatric spine showed that X-ray examination is still a good tool for diagnosing spinal growths compared with their scant utility in disc herniations (P = 0.001). During the survey we were impressed by the children's apparent good tolerance to pain, which is probably due to the lack of the emotional component of pain in adults and explains their delayed referral for neurosurgical consultation. However, all modalities of treatment seemed to be effective in children, chemonucleolysis and surgery being extraordinarily effective in this age group. Accordingly, we see no reason for long-term conservative therapy in children with lumbar and sciatic pain; on the contrary, we believe these patients should be offered earlier neurosurgical treatment.

Adolescent↗
PubMed2003

Vitamin A deficiency in the late gastrula stage rat embryo results in a one to two vertebral anteriorization that extends throughout the axial skeleton.

Vitamin A and its metabolites are known to be involved in patterning the vertebrate embryo. Study of the effect of vitamin A on axial skeletal patterning has been hindered by the fact that deficient embryos do not survive past midgestation. In this study, pregnant vitamin A-deficient rats were maintained on a purified diet containing limiting amounts of all-trans retinoic acid (12 microg atRA/g diet) and given a daily oral bolus dose of retinol starting at embryonic day 0.5, 8.25, 8.5, 8.75, 9.25, 9.5, 9.75, or 10.5. Embryos were recovered at E21.5 for analysis of the skeleton and at earlier times for analysis of select mRNAs. Normal axial skeletal development and patterning were observed in embryos from pregnant animals receiving retinol starting on or before E8.75. Delay of retinol supplementation to E9.5 or later resulted in a marked increase in both occurrence and severity of skeletal malformations, extending from the craniocervical to sacral regions. Embryos from the groups receiving retinol starting at E9.5 and E9.75 had one-vertebral anterior transformations of the cervical, thoracic, lumbar, and sacral vertebrae. Few embryos survived in the E10.5 group, but these embryos yielded the most severe and extensive anteriorization events. The skeletal alterations seen in vitamin A deficiency are associated with posterior shifts in the mesodermal expression of Hoxa-4, Hoxb-3, Hoxd-3, Hoxd-4, and Hoxa-9 mRNAs, whereas the anterior domains of Hoxb-4 and Cdx2 expression are unaltered. This work defines a critical window of development in the late gastrula-stage embryo when vitamin A is essential for normal axial skeletal patterning and shows that vitamin A deficiency causes anterior homeotic transformations extending from the cervical to lumbosacral regions.

Animals↗