PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “LUMBOSACRAL PLEXUS”

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 1,747 records · Page 97Linked to original sources
PubMed1995

[Penile block. Block of ilio-inguinal and iliohypogastric nerves in children. Techniques, indications, advantages and adverse effects].

Peripheral blocks as penile blocks, ilio-inguinal ou ilio-hypogastric nerve blocks provide an useful alternative to caudal block in children, especially for penile surgery, herniotomy, and orchidopexy, frequently performed at this age. A precise anatomic location and a strict technique increase the success rate of these blocks. Complications are rare. Postoperative analgesia in ambulatory surgery is one of the best reasons to select these techniques. In addition they avoid prolonged motor effects observed with epidural anaesthesia.

Child↗
PubMed1995

Acute heroin intoxication with complications of acute pulmonary edema, acute renal failure, rhabdomyolysis and lumbosacral plexitis: a case report.

After intravenous injection of heroin, a 27-year-old male with altered mental status and hypotension was seen at the Emergency Service where acute pulmonary edema was noted. The problem was resolved three days later after oxygen therapy had been administered by face mask. Acute renal failure, rhabdomyolysis and monoplegia of the patient's left leg were exhibited during his stay at the Intensive Care Unit. Neurological examination and electro-diagnostic studies (electromyography and nerve conduction velocity) showed left lumbosacral plexitis. Hemodialysis was given. Though the patient's hospital course was uneventful, satisfactory recovery from his left leg weakness, which persisted for one year after hospital discharge, was finally achieved.

Acute Disease↗
PubMed1994

[The superior gluteal nerve. Anatomical study of its extrapelvic portion and surgical resolution by trans-gluteal approach].

INTRODUCTION: The Transgluteal approach (TGa) to the hip, proposed by BAUER, and often used for total arthroplasties, could be responsible, according to some authors for bad clinical results, due to injury of the nervus gluteus superius (NGS). The aim of this study was to verify the nerve's anatomical condition and evaluate the risks of injury during TGa. MATERIAL AND METHODS: Thirty three dissections of fresh corpses in the lateral position (preceded by a TGa) permitted the estimation of the risk and the measurement of the distances between the nerve and the trochanter major (TM). The NGS was sought in the area of the foramen ischiaticum at the proximal side of the piriformis muscle after cutting the vessels and the fat. It was possible to follow it's branches to the end, but we had to lift the m. gluteus medius (mGM), or to cut it transversally. RESULTS: Many anatomical variations were found concerning the point of the nerve's division into 2 branches, nearer or farther from the foramen ischiaticum. The upper branch followed the proximal side of the gluteus minimus (GMin) then innervated the GM and the m. tensor fasciae latae (TFL). the lower branch showed a variable distribution of the strings to the three muscles (GM, GMin and TFL). The TFL's branch ended at upper side of the TM. A safe area, over the TM, without any nerve branches could be determined 7 cm above and behind the TM, 5 cm above it's posterior angle and 3 cm above it's anterior angle. During anterior TGa we noted that the coxofemoral dislocation could tear the GM's proximal fibers and threatened the "inter" or intramuscular nerve filaments. The acetabular exposition by retractors, could compress the more frontal branches. On the contrary using the posterior TGa, neither the dislocation nor the exposition seemed to threaten the nerve, which was farther away and more posterior. DISCUSSION: In this study we confirmed the existence of numerous anatomical variations of the NGS and classified them into 4 categories which include those already described in previous publications, of which the first category seems to be the most common. Our distances measured from the nerve to the TM are similar to those previously published, but our safe area is more restrictive than that proposed by Jacobs and Buxton. Respecting the limits of this area reduces the risk of nerve injuries. During the anterior TGa, the nerve is nearer to the TM and more exposed. The muscular mass innervated is large and the functional consequences of frontal injury must not be neglected. During acetabular exposition, the retractors should exert moderate muscular pressure, to avoid crushing them. The respect of the GMin, ensures adequate protection for the nerves situated between the muscles. To avoid muscular tearing during the anterior dislocation it is better to cut the collum femoris in place. The posterior approach seemed to be less dangerous for the nerves and muscles which are farther away. CONCLUSION: Strictly remaining within the limits of the safe area and carefully separating the muscles, should allow to decrease the risk of NGS injuries during TGa which seems to be more important in the anterior than in the posterior approaches.

Buttocks↗
PubMedDate not supplied

[Discogenic lumbosacral radiculitis].

A total of 74 patients with suspected discal hernia were studied. To clarify its diagnosis, epidural scintigraphy along with routine studies was used. The established diagnosis was verified during surgery. Carbonic acid laser was applied to 22 patients in addition to the conventional procedures.

Epidural Space↗
PubMed1993

[The clinical diagnostic aspects of chronic pain].

Four clinical signs of chronic pain as an independent suffering were defined in 2,010 patients with painful syndromes of various sites, including those that occurred in association with organic diseases. They are as follows: (1) The chaotic nature of spatial pain parameters; (2) Infinite limits of its temporary parameters; (3) Mutual suppression of "foci" of pain; (4) Replacement of the monocausal dependence by polycausal. The formation of painful syndromes is explained from phylogenetic viewpoints.

Chronic Disease↗
PubMed1994

Transcutaneous electrical localization and reversible blockade of the sacral nerve in the diagnosis of the urge syndrome.

To date, conventional urodynamic evaluation is not able alone to distinguish motor urgency with uninhibited detrusor contraction from sensory urgency. Transcutaneous electrical localization and reversible monolateral blockade of the 3rd sacral root was performed in 3 women with interstitial cystitis and in 2 men with idiopathic detrusor hyperreflexia by intranerve injection of 6 ml 0.5% Bupivacaine solution. The paralysis of the detrusor was completely reserved in all patients within 6 hours of the blockade. Cystometry and cystography were performed at 10 min, 2 and 6 hour intervals after the injection. In patients with the urge syndrome resulting from interstitial cystitis, there was a small increase in bladder capacity during the blockade. In contrast, the bladder capacity increased considerably during blockade in patients with idiopathic detrusor hyperreflexia. These results allowed us to differentiate the forms of the syndrome described above.

Diagnosis, Differential↗
PubMedDate not supplied

Failed back syndrome: a study on 95 patients submitted to reintervention after lumbar nerve root decompression for the treatment of spondylotic lesions.

The persistence of lumbar and nerve root pain after nerve root decompression surgery may be attributed to one of five causes; 1) progression of the spondylotic disease in the presence of peridural fibrosis; 2) recurrence of disc herniation or new hernia; 3) stenosis of the spinal or nerve root canal; 4) arachnoiditis; 5) vertebral instability. In most patients with peridural fibrosis and worsening of spondylotic lesions regression of nerve root symptoms was obtained after several months of conservative treatment, which continues to constitute essential treatment for most patients with recurrence of lumbar symptoms. The authors report the results obtained with the surgical treatment of 95 patients performed between 1981 and 1991 and divided into the categories listed above. Of these patients, 70 were submitted to further decompression surgery while 25 were submitted to posterolateral vertebral fusion. Reintervention obtained useful results in 83% of the cases where there had been recurrence of disc herniation; nerve root release obtained positive results in 100% of the cases where there was stenosis. Results obtained after wide decompression were poor in all of the cases with arachnoiditis; in these patients conservative treatment with T.E.N.S. can obtain a fair amount of control over pain. Positive results were obtained in 84% of the 25 patients submitted to posterolateral fusion for the treatment of vertebral instability, with fusion obtained in 96% of the cases. Surgical treatment is indicated for psychotic, neurotic patients or those with insurance-related motivations only when the organic cause of the symptoms is clearly evident.

Adolescent↗
PubMed1993

[Neoplastic lumbosacral plexopathy and "hot foot"].

Neoplastic lumbosacral plexopathy is a frequent and disabling complication in subjects with cancer. Its clinical presentation is characterized by pain, muscle weakness, sensory complaints in one or occasionally both limbs associated with the tumoral symptoms. The presence of autonomic symptoms is less frequent; one of these is the "hot and dry foot". We present two patients, one with prostatic cancer and the other with myxoid liposarcoma, who developed a lumbosacral plexopathy as a manifestation of the extension of the neoplastic process; in both cases there was in addition a clear difference in the temperature of the affected limb. Although infrequent, the "hot and dry foot" it constitutes an early sign of metastatic plexopathy which facilitates the differential diagnosis with preforaminal lumbosciatic radiculopathies.

Adult↗
PubMedDate not supplied

[Computed tomography in the diagnosis of intervertebral disk hernias].

Computed tomography (CT) was conducted in 75 patients with discogenic radiculitis. In 15 patients the study was carried out without intensified contrasting of the spinal cord meningeal spaces (native CT), in 60 with contrasting of the meningeal spaces with air (42 patients) or Omnipaque (18 patients). The CT was analysed at the level of the bony and articular segments of the spinal canal. Deformity of the dural sac of the spinal cord was the most frequent sign of Schmorl's body. It was encountered in 96.2% of verified cases. CT is one of the methods for establishing the diagnosis of Schmorl's body.

Adult↗
PubMed1993

Meralgia paresthetica: a complication of laparoscopic herniorrhaphy.

Laparoscopic herniorrhaphy is a new and presently evolving technique applied to the repair of inguinal defects. Many different authors have described various methods by which this can be achieved. Some of these include the transabdominal preperitoneal approach, the plug technique, the intraperitoneal onlay of mesh, and the extraperitoneal approach. The authors have performed 252 laparoscopic hernia repairs utilizing a form of the transabdominal preperitoneal procedure that is referred to as the "transperitoneal anatomic approach." The development of new procedures or the modification of existing procedures can create new problems or alter the pattern of traditional complications. These problems must be thoroughly evaluated and reported if repetition of these errors is to be avoided. Five cases of meralgia paresthetica are reported that resulted from staple entrapment of the lateral femoral cutaneous nerve during laparoscopic herniorrhaphy. An understanding of the preperitoneal inguinal anatomy and precise placement of staples will allow avoidance of this complication.

Adult↗
PubMed1993

Pudendal nerve palsy induced by fracture table.

There are 23 cases in the literature of fracture table-induced pudendal nerve palsy. The majority of these patients had full sensory return; however, return of sexual function was unpredictable. The relevant anatomy, etiology, and incidence of this complication are discussed, and suggestions are made for its prevention.

Female↗
PubMed1977

An electrophysiological method for examining lumbosacral root compression.

The propagation velocities and conduction times of nerve impulses responsible for muscle F-waves were measured in the proximal segments of 60 normal posterior tibial nerves and of 41 normal peroneal nerves. The results were compared with those of 25 patients having confirmed lumbosacral root compression due to disc degeneration. Using the peroneal nerve, 65 per cent of patients had a prolonged proximal conduction time; a similar abnormality was found in 56 per cent of patients when the posterior tibial nerve was studied. The yield of positive results rose to 85 per cent and 76 per cent respectively when the M- and F-latencies in given individuals were compared. It was also shown that in normal subjects the F-response has a longer latency, and slower conduction velocity than the H-reflex when both are obtained using the same stimulating and recording sites. In patients in whom the ankle jerks and H-reflexes are absent, the F-waves may still be recorded indicating that the latter are mediated through motor fibers.

Adolescent↗
PubMed1996

The afferent pathways of discogenic low-back pain. Evaluation of L2 spinal nerve infiltration.

The afferent pathways of discogenic low-back pain have not been fully investigated. We hypothesised that this pain was transmitted mainly by sympathetic afferent fibres in the L2 nerve root, and in 33 patients we used selective local anaesthesia of this nerve. Low-back pain disappeared or significantly decreased in all patients after the injection. Needle insertion provoked pain which radiated to the low back in 23 patients and the area of skin hypoalgesia produced included the area of pre-existing pain in all but one. None of the nine patients with related sciatica had relief of that component of their symptoms. Our findings show that the main afferent pathways of pain from the lower intervertebral discs are through the L2 spinal nerve root, presumably via sympathetic afferents from the sinuvertebral nerves. Discogenic low-back pain should be regarded as a visceral pain in respect of its neural pathways. Infiltration of the L2 nerve is a useful diagnostic test and also has some therapeutic value.

Adolescent↗
PubMed1996

[Sciatic nerves block].

Sciatic nerve block is considered difficult to perform, but very useful for lower limb anaesthesia and analgesia. The use of a nerve stimulator makes the technique easier. Functionally, it is better to consider that there are three independent sciatic nerves, namely, the posterior cutaneous nerve, the tibial nerve and the common peroneal nerve. Searching for blocking these three nerves and especially the latter two, specifically improve the reliability and quality of blockade.

Anesthetics, Local↗