PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “LUMBOSACRAL REGION”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed1999

[Common iliac artery false aneurysm as complication of lumbar disc hernia surgery. Case report].

Surgery for discogenic disease of lumbar region is a challenging and diverse field. The significance of complications in disc surgery arises from the possibility that failure of primary treatment may lead to a permanently disable patient. The most common iatrogenic lesions in the posterior approach to lumbar disc herniation are neurologic, vascular, enteric, ureteral, and sexual dysfunction. Abramovitz reports that vascular complications of the posterior approach occur in at least 0.1% of cases. The vascular complications may present during surgery as severe bleeding leading to hypotension. The most common late complication is arteriovenous fistula followed by false aneurysms. We describe the case of a 39 year-old woman who was operated on for a lumbar disc herniation in other hospital. She came to us with a persistent pain in lumbar area. A MRI scan of lumbosacral region revealed a paravertebral lesion suggesting abscess. An angiography was performed and showed a false aneurysm of left common iliac artery, which was surgically treated successfully. We discuss the mechanisms of lesion and precautions against vascular ones during lumbar disc surgery.

Adult↗
PubMed1992

[Clinical manifestations of spinal lesions in dysraphic malformations of the caudal neuropore in children].

Disorders in the development of the spine and the spinal cord in the caudal neuroporus region significantly contribute to the morbidity and the lasting invalidity of children. Clinical investigations of the malformations manifest through different forms of body abnormalities, ranging from asymptomatic forms of "spina bifida occultae" to the severe forms of open "meningomyelocele". The nature and the level often cannot be detected before the development of the structural changes in the course of growth and development of the child, which can hardly be treated later. At the Department of Child Surgery in Novi Sad 12 infants were surgically treated in the last 5 years, while 30 children were surgically and conservatively treated after the detection of the clinical and subclinical manifestations of dysraphism. The indications for the surgical treatment were open meningomyelocele as well as those subclinical forms indicating the development of the tethered corn syndrome, hydrocephalus and tumefactions in the lumbosacral region. Moreover the study points to the significance of certain clinical features and investigations in the diagnosis of spinal dysraphism.

Cauda Equina↗
PubMed1996

[Anal sphincter electromyography, bulbocavernosus reflex and pudendal somatosensory evoked potentials in diagnosis of neurogenic lumbosacral lesions with disorders of bladder and large intestine emptying and erectile dysfunction].

The diagnostic value of anal sphincter electromyography (EMG), electrical bulbocavernosus reflex (BCR) and pudendal somatosensory evoked potentials (SEP) was studied in 16 male patients with disturbances of bladder function or defecation or with erectile dysfunction (ED) of at least several weeks' duration. All 16 patients had proven neurogenic disorders in the lumbosacral region. Eleven presented with bladder dysfunction, four with defecation problems, and nine with ED (some had more than one symptom). Fifteen patients had a pathological sphincter EMG, 14 patients a pathological BCR, and six patients a pathological pudendal SEP. Thus, the sphincter EMG was the most sensitive technique in the diagnosis of chronic pudendal lesions. However, pure afferent lesions cannot be detected by the sphincter EMG. In this case, the BCR, using unilateral stimulation of the dorsal nerves of the penis, provides the opportunity to distinguish between afferent and efferent lesions of the sacral reflex arc.

Adult↗
PubMed1996

Patterns of neuronal differentiation in neural tube mutant mice: curly tail and Pax3 splotch-delayed.

A battery of antibodies was used to assess development of the spinal cord and its neurons in mouse embryos with neural tube defects (NTDs). The two mutant strains examined, curly tail (ct) and splotch-delayed (Pax3Sp-d), develop an open neural tube for unrelated reasons, and thus provided for a complementary analysis. Five percent of embryos homozygous for the ct gene and 89% of embryos homozygous for the Pax3Sp-d gene develop spina bifida in the lumbosacral region of the neuraxis. Expression of several neuronal antigens, including Islet-1/2, polysialylated neural cell adhesion molecule (NCAM), neurofilaments, and a neuronal-specific nuclear protein (Neu-N) recognized by monoclonal antibody A60, were used as indicators of the level of differentiation of neuronal tissue. Immunohistochemical labeling suggests that early (embryonic days 12-15) neuronal differentiation in the dorsal and ventral region of the dysraphic neural tube occurs remarkably normally in both of the mutants. Similarly, labeling with antibodies to NCAM and neuroafilaments indicate that axonal development during early neurogenesis is unperturbed. Later stages of neuronal maturation, however, do not occur in the usual manner. Instead, the neuronal tissue begins a prodigious degeneration at embryonic day 17 (E17), so that by E18 only a rudimentary tissue remains. These results suggest that the aberrant morphology of the neural tube does not affect neuronal differentiation. However, the anomalous morphological and chemical environment may contribute to the neuronal degeneration observed at later stages.

Animals↗
PubMed1985

Myxopapillary ependymoma. A clinicopathologic and immunocytochemical study of 77 cases.

The study involved 77 myxopapillary ependymomas of the spinal cord encountered during a 60-year period (1924-1983). This variant of ependymoma was, with few exceptions, limited to the lumbosacral region, particularly the filum terminale. The male:female ratio was 1.7:1, and the mean age at diagnosis was 36.4 years (range, 6-82); at presentation, 15 (19%) of the patients were in the first two decades of life. The duration of symptoms ranged from 1 month to 30 years; the most frequent complaint was low-back pain, and eight patients had undergone prior "disc surgery." Generally, myelographic block was disclosed. Preoperative cerebrospinal fluid protein levels averaged 2462 mg/dl. Myxopapillary ependymomas are slow-growing tumors that show no significant tendency to histologic dedifferentiation. Despite some variation in cytologic features and the presence of atypia and modest mitotic activity in most cases, the gross characteristics of the tumors appear to be of greater prognostic significance than the histologic features. Tumors that were encapsulated (25%) and amenable to intact, total surgical removal had a recurrence rate of 10%, whereas those that were removed either piecemeal (34%) or subtotally (41%) had recurrence rates of 19%. Overall survival, however, was more closely related to residual disease; total removal of tumor, whether intact (encapsulated) or piecemeal, resulted in longer survival (19 years) than did subtotal resection (14 years). Patients who died (6.5%) did so after a prolonged course marked by multiple recurrences. Radiotherapy may be of particular benefit to patients whose tumors are not amenable to intact total removal.

Adolescent↗
PubMed1989

Sacrococcygeal extradural ependymoma.

A case of lumbosacral extradural myxopapillary ependymoma is reported. The clinical, embryologic, and therapeutic features of this rare lesion are presented. The unusual entity is discussed in the light of previous experience with extradural ependymoma in the lumbosacral region.

Adult↗
PubMed1994

Genetic models of mammalian neural tube defects.

Several mouse mutations disturb the embryonic process of neurulation, yielding neural tube defects. Analysis of the mutations offers the most feasible approach to understanding the aetiology and pathogenesis of human neural tube defects. Interactions between the non-allelic mutant genes and between several of the mutant genes and modifying genes in the genetic background modulate the frequency and severity of the defects that develop. Environmental factors interact with the genetic predisposition either to increase or to decrease the incidence of defects. The gene loci corresponding to two of the mutations, splotch (Sp) and extra toes (Xt), have been identified as those encoding the transcription factors Pax-3 and Gli3, respectively; their human homologues are associated with Waardenburg type I syndrome and Greig's cephalopolysyndactyly. Embryological analysis reveals that several of the mutations disturb the process of neural tube closure at the posterior neuropore (in the lumbosacral region), yielding spina bifida and/or tail defects. The different mutations appear to achieve this developmental end-point by different underlying mechanisms. In curly tail (ct), non-neural tissues proliferate abnormally slowly causing ventral curvature of the neuropore region and inhibiting neural tube closure. Neural tube defects can be prevented in cultured ct/ct embryos by experimentally correcting either the proliferative imbalance or the ventral curvature. In Sp the primary defect appears to reside in the neuroepithelium. A combination of genetic analysis, gene cloning and experimental embryology is revealing that neural tube defects in mice and, by implication, in humans are a developmentally heterogeneous group of malformations.

Animals↗
PubMed1976

Myelinated nerve cell bodies in the dorsal horn of the monkey (Saimiri sciureus).

While observing electronmicroscopic preparations of laminae I-III of Rexed ('52), taken from the lumbosacral region of squirrel monkey spinal cord, several small neuronal cell bodies were found which were partially or completely encircled by compact myelin sheaths of varying thickness. Though found in all three laminae, the occurrence of these perikaryal sheaths was less frequent in the "inner zone" of lamina II where there were few myelinated fibers. Perikaryal profiles which were completely surrounded by myelin exhibited meither internal mesaxons nor external tongue processes and the origin of their myelin is obscure. In cases of partially enveloped cells the myelin was often clearly derived from extensions of myelin sheaths surrounding small-diameter axons. These overgrowths of myelin extended away from their axons at a pole near their internal mesaxon and spread out across the surface of neighboring nerve cells. In some cases the extensions were derived from the entire axonal sheath while in others only the external lamellae were included. The external tongue process, when observed, was located at the distal end of the axonal myelin extension. Overgrowths of axonal myelin which were unrelated to neuronal cell bodies were also found but these formations were less extensive.

Animals↗
PubMed1980

Characterization of intercellular junctions in the caudal portion of the developing neural tube of the chick embryo.

The types of intercellular junctions present within caudal levels of the chick neural tube (i.e., future lower thoracic and lumbosacral regions of the spinal cord) were determined by freeze-fracture of stage 14 to 16 embryos. Two levels of the developing neural tube were examined: the region of the neurulation overlap zone--consisting of primary neural tube dorsally and secondary neural tube ventrally--and the portion of the primary neural tube located just cranial to the overlapping region. Gap junctions were the most numerous type of intercellular junction present within the primary neural tube. These junctions were located primarily in juxtaluminal areas, near the apices of neuroepithelial cells, and sometimes also at the bases of these same cells. In addition, focal, poorly defined tight junctions occasionally occupied juxtaluminal regions of the primary neural tube. The medullary cord (i.e., the immediate precursor of the secondary neural tube) and secondary neural tube contained gap junctions exclusively. Gap junctions were first found in these areas at the lateral borders of the medullary cord, concomitant with formation of this structure, and then at the interface between the elongated, peripheral cells of the cord and the irregularly shaped and loosely arranged central cells of this structure. Finally, gap junctions were distributed radially around secondary lumina formed by cavitation. The precise spatial and temporal correlation between the appearance of gap junctions and the specific changes occurring in cellular morphology and arrangement during secondary neurulation strongly suggest that gap junctions may have a role in coordinating cellular activities during formation of both the medullary cord and the secondary neural tube.

Animals↗
PubMed1994

Poland anomaly with unusual associated anomalies: case report of an apparent disorganized defect.

We report on a 2 1/2-year-old boy with absence of clavicular head of pectoralis major on the left side, ipsilateral upper limb anomalies, and anomalies of the lower limbs such as popliteal webbing, median cleft of right foot, bifid left hallux, syndactyly of toes, and toenail hypoplasia. Other anomalies included undescended testis, hairy nevus in the lumbosacral region, and a pedunculated finger-like tag on the right thigh. The pathogenesis of these associated anomalies cannot be explained on the basis of compromised local blood supply alone. A possible link with the disorganization mutation is discussed.

Abnormalities, Multiple↗
PubMed1994

Schinzel-Giedion syndrome: autopsy report and additional clinical manifestations.

Schinzel-Giedion syndrome (SGS) is a rare and incompletely defined condition. This is the third postmortem study on a boy with SGS and other unusual findings. He had a primitive neuroectodermal tumor in the lumbosacral region, bilateral syndactyly of hands and feet, and brain anomalies in addition to the major manifestations of the syndrome. We consider these clinical findings as possible additional manifestations of the syndrome since, of 19 SGS patients reported, 4 had syndactyly and 3 had embryonal tumors. In addition, the 3 published necropsy studies report brain anomalies. Knowledge that these changes occur in SGS may help facilitate diagnosis and improve our understanding of the syndrome.

Abnormalities, Multiple↗
PubMed2006

Differences in spinal distribution and neurochemical phenotype of colonic afferents in mouse and rat.

Visceral pain is a prevalent clinical problem and one of the most common ailments for which patients seek medical attention. Recent studies have described many of the physiological properties of visceral afferents, but not much is known regarding their anatomical characteristics. To determine the spinal distribution and neurochemical phenotype of colonic afferents in rodents, Alexa Fluor-conjugated cholera toxin-beta (CTB) was injected subserosally into the proximal and distal portions of the descending colon in Sprague Dawley rats and C57Bl/6 mice. Dorsal root ganglia (T10-S2) were processed for fluorescent immunohistochemistry and visualized by confocal microscopy. In the mouse, CTB-positive neurons were most numerous in the lumbosacral region (LS; L6-S1), with a smaller contribution in the thoracolumbar ganglia (TL; T13-L1). In contrast, CTB-positive neurons in the rat were most numerous in the TL ganglia, with a smaller contribution in the LS ganglia. The vast majority of CTB-positive neurons in both mouse and rat were positive for TRPV1 and CGRP and most likely unmyelinated, in that most colonic afferents were not positive for neurofilament heavy chain. In the mouse, the TL ganglia had a significantly higher percentage of TRPV1- and CGRP-positive neurons than did the LS ganglia, whereas no differences were observed in the rat. The high incidence of TRPV1-positive colonic afferents in rodents suggests that hypersensitivity from the viscera may be partially a TRPV1-mediated event, thereby providing a suitable target for the treatment of visceral pain.

Afferent Pathways↗
PubMed1980

Development of chick paravertebral sympathetic ganglia. I. Fine structure and correlative histofluorescence of catecholaminergic cells.

Paravertebral sympathetic ganglia from the lumbosacral region of a series of chick embryos have been studied with electron microscopic methods, including aldehyde-osmium and permanganate fixatives, and correlative histofluorescence (Grillo et al, '74). Our purpose was to assess the differentiation of catecholaminergic (CA) cells during histogenesis in ovo. Examination of comparable adult ganglia as a baseline for differentiating stages confirmed that the principal sympathetic neuron (PN) is similar to those of other species in that it contains predominately small dense-cored vesicles (SDCV) preserved only by permanganate, and does not histofluoresce following the method of Grillo et al. ('74). At embryonic day (E) 7--8, when ganglia have just formed, areas fluorescing bright yellow-green are correlated with two types of cells: 1) Neuroblasts with vesicular nuclei and large dense-cored vesicles (LDCV) are common. As the neuroblasts grow and differentiate, LDCV move away from perikaryal cytoplasm into developing processes. Around E13-15, LDCV appear in the neuroblasts which continue to develop until they resemble miniature adult PN in late embryos and hatchlings. 2) Granule (GR) cells with clumped chromatin and sparse cytoplasm are clustered in te ganglionic periphery at E7-8, but are rare. The GR cells increase somewhat in size and numbers by E11, but retail essentially the same characteristics as at earlier stages. Neither bright fluorescence nor GR cells appear later than stages E13-15. These results are interpreted to mean that when chick sympathetic stem cells have migrated from the primary ganglia into the paravertebral ganglia, they give rise to two separate lines of CA cells, one of which is not maintained and subsequently disappears. The results are significant as a basis for understanding how a mixed population of CA cells might arise within sympathetic ganglia in situ.

Animals↗
PubMed1984

The distribution and origin of a novel brain peptide, neuropeptide Y, in the spinal cord of several mammals.

The distribution of neuropeptide Y [NPY]-immunoreactive material was examined in the spinal cord and dorsal root ganglia of rat, guinea-pig, cat, marmoset, and horse. Considerable concentrations of NPY and similar distribution patterns of immunoreactive nerve fibres were found in the spinal cord of all species investigated. The dorsal root ganglia of the cat and the horse contained numerous immunoreactive nerve fibres, but in these species, as in the other three studied [rat, guinea-pig, marmoset], no positively stained cell bodies were found. Neuropeptide Y-immunoreactive nerves were observed at all levels of the spinal cord, being most concentrated in the dorsal horn. In the rat, guinea-pig, and marmoset, there was a marked increase of NPY-immunoreactive fibres in the lumbosacral regions of the spinal cord, and this was reflected by a considerable increase of extractable NPY. Estimations of NPY-immunoreactive material in the various regions of the rat spinal cord were as follows: cervical, 13.8 +/- 1.0; thoracic, 21.1 +/- 2.5; lumbar, 16.3 +/- 2.9; sacral, 92.4 +/- 8.5 pmol/gm wet weight of tissue +/- SEM. In the ventral portion of the guinea-pig spinal cord they were as follows: cervical, 7.1 +/- 1.2; thoracic, 8.2 +/- 3.6; lumbar, 22.6 +/- 7.0; sacral, 36.7 +/- 9.5 pmol/gm wet weight of tissue +/- SEM. Analysis of spinal cord extracts by reverse phase high performance liquid chromatography [HPLC] demonstrated that NPY-immunoreactive material elutes in the position of pure NPY standard. No changes in the concentration and distribution of the NPY-like material in the rat spinal cord were observed following a variety of surgical and pharmacological manipulations, including cervical rhizotomy, sciatic nerve section and ligation, and local application of capsaicin [50 mM] to one sciatic nerve. It is therefore suggested that most of the NPY-immunoreactive material in the spinal cord is derived either from intrinsic nerve cell bodies or from supraspinal tracts.

Animals↗
PubMed1987

Development of the glycogen body of the Japanese quail, Coturnix japonica. I. Light microscopy of early development.

The glycogen body is a functionally enigmatic structure located in lumbosacral region of the spinal cord in birds. This tissue is unique to birds, and, although it is believed to be present in all species, studies on the glycogen body to date have been confined largely to the domestic chicken. The present study is the first to describe the glycogen body of the Japanese quail (Coturnix japonica) during incubation and at hatching. Light microscopy and histochemistry were used to identify the glycogen body in the spinal cord of the developing quail beginning at 7 days of incubation and to ascertain the presence of nerve fibers in that tissue at hatching.

Animals↗
PubMed2002

Homocysteine modifies development of neurulation and dorsal root ganglia in chick embryos.

BACKGROUND: The formation of the neural tube (neurulation) involves two mechanisms: primary and secondary neurulation. In chicks, there is also an overlap zone, where both mechanisms work together. Homocysteine (Hcy) may have an important teratogenic role in neural tube defects (NTD) when folic acid levels are considered normal. Recently, Hcy capability to generate NTD and modify neural crest cell migration has been demonstrated in chick embryos. This study was aimed to evaluate the effects of Hcy on neurulation and the development of the dorsal root ganglia (DRG). METHODS: Chick embryos were treated with L-Hcy thiolactone 20 micromol to produce the highest rate of survival with embryos carrying neural tube defect (NTD) in the spine. Embryos at stages (st) 3-10 were treated and harvested at st 18-23. Only externally normal embryos or those carrying spinal NTD embryos were considered. RESULTS: Histological sections of Hcy-treated embryos showed: open spina bifida (39% of embryos), more than one tube forming the spinal cord (26%), disorganized spinal cord (26%), always affecting lumbosacral regions, probably in the overlap zone. Additionally, 32% of embryos had small and continuous DRG, associated with a slimmed roof plate. Three-dimensional reconstruction showed unsegmented DRG until the C8 ganglion level. There was a 75% reduction of C3 DRG cells in treated embryos in comparison to untreated ganglia. CONCLUSION: Hcy teratogenicity in avian embryos affected the neural tube in the overlap zone, secondary neurulation and the cervical DRG.

Animals↗