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Results for “LUMBOSACRAL PLEXUS”

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At least 1,783 records · Page 99Linked to original sources
PubMed1998

Short-term evaluation of periradicular corticosteroid injections in the treatment of lumbar radiculopathy associated with disc disease.

OBJECTIVES: The purpose of this study was to evaluate the feasibility and efficacy of periradicular corticosteroid injections performed under fluoroscopic guidance in the treatment of pain originating in the lumbosacral nerve roots. METHOD: Forty patients presenting with lumbosciatica or femoral neuralgia unresponsive to conventional conservative treatment were admitted to the study. Patients with nerve root pain due to infectious, tumorous or inflammatory diseases were excluded, as were patients who needed immediate surgery. Pain was evaluated using a visual analog scale on the day of the injection and ten (D10) and ninety (D90) days later. RESULTS: All patients were evaluated as scheduled on D10 and D90. The mean visual analog scale score decreased from 53.3 mm at baseline to 30.1 mm on D10 and to 21.8 mm on D90. Ninety per cent of patients had a visual analog pain score decrease on D10 and 85% on D90. Reported side effects were two cases of mild spontaneously regressive acne and one case of radicular pain exacerbation of less than one day's duration. CONCLUSION: Periradicular injections of corticosteroids done under fluoroscopic guidance as an outpatient procedure was effective and safe in our study and may deserve to be used as part of the conservative management of lumbar nerve root pain before resorting to more invasive methods.

Acne Vulgaris↗
PubMed1998

[Long-term results of radical lumbar ganglionectomy. Our experience].

We present our experience of 15 patients operated on by lumbar sympathectomies between 1987-1993, to confirm the effective and permanent efficacy of sympathectomy in peripheral vascular disease of the lower limbs. The patients, 9 men and 6 women (age 58-86) presented with rest pain (12), and minimal toe lesions (3). After an eco color-Doppler and angiography of the lower limbs, a radical operative sympathectomy (L2-L5) was performed in all patients. Associated diseases were: ischemic cardiopathy (61.7%), renal failure (25%), diabetic disease (61.7%), carotid stenosis (25%), abdominal aortic aneurysm (12%). In four patients, was performed during the same surgical time, 2 abdominal aortic aneurysm repairs, and 2 aorto-bifemoral bypasses. No patients died, operative morbidity was 12.5% (2 cases). The clinical and instrumental follow-up performed on 6 patients (38.3%) after 3 years, demonstrated in all cases the regression of the rest pain (12 patients) and the healing of the toe lesions (3 diabetic patients). Our results confirm the efficacy of sympathectomy especially when performed in young patients. The small number of diabetic patients in our study made statistical evaluation difficult, but it is generally considered that the results are worse in diabetic patients, because the microvascular lesions in these patients reduce peripheral vasodilatation.

Aged↗
PubMedDate not supplied

[Laser puncture diskectomy in discogenic lumbosacral radiculitis].

Percutaneous laser discectomy (PLD) was performed in 273 patients with herniated disc-induced lumbosacral radiculitis. Indications for PLD were based on clinical and neurological findings and results of MR tomography: no benefit from conservative treatment, pain syndrome in the lumbago stage and sciatica not presenting with severe paresis and with herniated intervertebral discs down to 6 mm in size across.

Adult↗
PubMed1998

[Electric stimulation of sacral roots for the treatment of urinary incontinence due to detrusor instability: application of a technique and results in a clinical case].

OBJECTIVE: To describe a case treated with a new technique in our therapeutic algorithm for non-neurogenic vesicourethral dysfunction. METHODS/RESULTS: A 47-year-old female underwent retropubic urethropexy for stress urinary incontinence. She remained incontinent due to detrusor instability to a degree that was socially unacceptable. After conservative treatment had failed, a percutaneous electrode was applied to the sacral nerve root and she received electrical stimulation of 4-6 milliamperes, 15 Hz and 200 microseconds duration for 7 days. Incontinence remitted for as long as 3 months after the electrode had been removed. CONCLUSION: The results achieved with sacral nerve electrical stimulation reported in the literature and our results support the use of this technique in urological clinical practice.

Electric Stimulation Therapy↗
PubMed1998

Retroperitoneal endoscopic lumbar sympathectomy with balloon dissection: experience with a cadaveric model.

The objective of this study was to determine the feasibility of retroperitoneal endoscopic lumbar sympathectomy with balloon dissection technique using a cadaveric model. Retroperitoneal endoscopic lumbar sympathectomy was performed on 10 cadavers. The procedure was combined with balloon dissection to provide easier visualization and more working space. The outcome was successful in eight cadavers. Average operating time was 40 min, and visualization was good. The only major technical problems were perforation of the peritoneum and air leak into the abdomen. It was concluded that retroperitoneal endoscopic lumbar sympathectomy with balloon dissection has the advantages of minimal invasiveness, clear visualization, and controlled blunt dissection. The use of a cadaveric model may improve the clinical learning curve.

Cadaver↗
PubMed1998

Morphometric evaluation of the sacral dorsal root ganglia. A cadaveric study.

An anatomic study of the sacral dorsal root ganglia (DRG) was performed to determine the location and dimensions of the S1-4 DRGs and to correlate this information to sacral nerve root ganglion lesions. S1 DRGs were located in the intraforaminal region in 55-60% and in the intracanalar region in 40-45%. S2 DRGs were in the intraforaminal region in 15-50% and in the intracanalar region in 50-85%. All the S3 and S4 DRGs were located in the intracanalar region. None of the sacral DRGs was located in the extraforaminal region. The intraforaminal position of the S1 and S2 ganglia renders them vulnerable to compression caused by sacral fractures involving the sacral foramina because of the little space available for these ganglia in the foraminal region. The S1 DRG, with its its relatively larger dimensions and its intracanalar position relative to the other sacral DRGs, may be susceptible to compression by the L5-S1 disk herniation. Its intraforaminal position may predispose it to injury during S1 or S2 pedicle screw placement.

Aged↗
PubMed1998

[Video-taped utero-sacral ablation, an alternative treatment of primary incapacitating dysmenorrhea].

Incapacitating dysmenorrhea has been treated in many different ways both medical and surgical. The best result yet is by uterosacral ablation. The purpose of this study is to demonstrate the utility of uterosacral ablation as treatment for incapacitating dysmenorrhea. This is a prospective longitudinal study of a cohort in which patients were their own controls. The no probabilistic sample of work was of 15 patients in the service of Gynecology being studied for incapacitating primary dysmenorrhea, under treatment for at least three months without favorable response. Videolaparoscopy was performed using CO2 as distention gas. A 10 mm lens grand angular Storz Karl and monopolar feeding was used for the ablation. Follow up was for six to sixteen months, grading the response to treatment in absent, mild, moderated and good. Considering a good response was when pain allowed daily activity. X2 was used at a level of significance of 0.05. In relationship with pain one (7%) was asintomatic, nine (50%) were mild, three (20%) moderate, two (13%) remained with no changes. Comparing the difference pre and post treatment had, statistical significance on a P 0.0025 was in favor of the improvement. We conclude in spite of the smallness of the sample, results are encouraging because any degree of improvement is of benefit to the patient for her quality of life.

Adolescent↗
PubMedDate not supplied

Sacral plexopathy and sciatic neuropathy after total knee arthroplasty.

While peroneal and tibial neuropathies have been described as a complication of total knee arthroplasty (TKA), a computerized literature search failed to reveal any previously reported cases of associated sacral plexopathy or sciatic neuropathy. This case report describes the diagnosis and management of a patient found to have evidence of a right sacral plexopathy and a left sciatic neuropathy, following bilateral TKA. This case suggests that these may be rare complications of TKA.

Arthroplasty, Replacement, Knee↗
PubMed1998

Pelvic floor function/dysfunction and electrodiagnostic evaluation.

The pelvic floor provides support for the bladder, rectum, and genital systems, as well as proper positioning and orientation of the urethral and anal sphincters. Impairment may result in prolapse, urinary and fecal incontinence, and sexual dysfunction. The impact is enormous in terms of personal, social, and financial burden. Pertinent anatomy is presented, followed by an overview of available electrodiagnostic techniques and a description of pudendal nerve conduction studies, sacral reflex testing and selected electromyographic techniques. Clinical applications are discussed throughout the text and the need for further research is addressed.

Anal Canal↗
PubMed1999

Three pathways between the sacroiliac joint and neural structures.

BACKGROUND AND PURPOSE: Despite ongoing clinical suspicion regarding the relationship between sacroiliac joint (SIJ) dysfunction and lower extremity symptoms, there is a paucity of scientific literature addressing this topic. The purpose of this study was to describe patterns of contrast extravasation during SIJ arthrography and postarthrography CT in patients with lower back pain and to determine whether there are pathways of communication between the SIJ and nearby neural structures. METHODS: Fluoroscopically guided SIJ arthrography was performed on 76 SIJs. After the injection of contrast medium, anteroposterior, lateral, and oblique radiographs as well as 5-mm contiguous axial and direct coronal CT images were obtained. Contrast extravasation patterns were recorded for each joint. These observations included a search for contrast extravasation from the SIJ that contacted nearby lumbosacral nerve roots or structures of the plexus. RESULTS: Sixty-one percent of all joints studied revealed one of five contrast extravasation patterns. Three of these observed patterns show a pathway of communication between the SIJ and nearby neural structures. These included posterior extravasation into the dorsal sacral foramina, superior recess extravasation at the sacral alar level to the fifth lumbar epiradicular sheath, and ventral extravasation to the lumbosacral plexus. CONCLUSION: Three pathways between the SIJ and neural structures exist.

Adult↗