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'Sacral Plexus' (35211)


Feb
2018

The pathogenesis of intraneural ganglion cysts is controversial. Recent reports in the literature described medial plantar intraneural ganglion cysts (mIGC) with articular branches to subtalar joints. The aim of the current study was to provide further support for the principles underlying the articular theory, and to explain the successes and failures of treatment of mICGs.

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Feb
2018

Long-term morbidity after multimodal treatment for rectal cancer is suggested to be mainly made up by nerve-injury-related dysfunctions. Stereotactic navigation for rectal surgery was shown to be feasible and will be facilitated by highlighting structures at risk of iatrogenic damage. The aim of this study was to investigate the ability to make a 3D map of the pelvic nerves with magnetic resonance imaging (MRI).

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Dec
1969

Although the safety and effectiveness of the short-axis in-plane method has been confirmed for lumbar plexus block, the operation is difficult and has a high rate of epidural spread at the plane of the articular process. Therefore, we developed a new in-plane technique, called the beach chair method, which displays images from the transverse process. We compared the operative difficulty and incidence of epidural spread of the beach chair method with those of the control method (at the plane of the articular process) in this randomized controlled clinical trial.

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Jan
2018

To perform in vivo isotropic-resolution diffusion tensor imaging (DTI) of lumbosacral and sciatic nerves with a phase-navigated diffusion-prepared (DP) 3D turbo spin echo (TSE) acquisition and modified reconstruction incorporating intershot phase-error correction and to investigate the improvement on image quality and diffusion quantification with the proposed phase correction.
Phase-navigated DP 3D TSE included magnitude stabilizers to minimize motion and eddy-current effects on the signal magnitude. Phase navigation of motion-induced phase errors was introduced before readout in 3D TSE.

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Jan
2018

A middle rectal artery arising from the lateral sacral artery (MRAls) in the right pelvis of a 99-year-old male was observed. Although variations of the origin of the middle rectal artery have been reported on many occasions, there are few descriptions of the trajectory in the literature. In our case, the MRAls branched from the lateral sacral artery on the sacral surface close to the third sacral sympathetic ganglion and immediately penetrated the third sacral splanchnic nerve and the parasympathetic pelvic splanchnic nerve from the ventral ramus of the forth sacral nerve.

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Jan
2018

We describe the unique case of a 51-year-old lady who developed a contralateral lumbosacral plexopathy two days after a lumbar microdiscectomy. This is the first report to date of this complication occurring following this procedure. We review the literature regarding lumbosacral plexopathy and discuss the evidence base behind investigating and managing this condition and the potential pathophysiological mechanisms which underlie its development.

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Jan
2018

Spinal cord arteriovenous shunts (scAVSs) are a group of lesions located in the spinal cord itself or in the surrounding structures. The most common scAVSs are spinal dural arteriovenous fistulas (sDAVFs), which are acquired lesions. The pathogenesis of sDAVFs involves thrombosis and venous hypertension as trigger factors.

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Dec
1969

To present the current understanding of normal anatomy, physiology, sexual physiology, pathophysiology and the consequential sexual changes and dysfunctions following a spinal cord injury (SCI).Narrative review of the latest literature.Peripheral innervations of the pelvis involve 3 sets of efferent neurons coordinated though the pelvic plexus (somatic, thoracolumbar sympathetic, and sacral parasympathetic), and these are under cerebral descending excitatory and inhibitory control.

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Dec
2017

This mini review describes the current surgical strategy for restoring function after traumatic spinal nerve root avulsion in brachial or lumbosacral plexus injury in man. As this lesion is a spinal cord or central nervous injury functional return depends on spinal cord nerve cell growth within the central nervous system. Basic science, clinical research and human application has demonstrated good and useful motor function after ventral root avulsion followed by spinal cord reimplantation.

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Jan
2018

Isotropic high-resolution three-dimensional (3D) magnetic resonance neurography (MRN) is increasingly used to depict even small and highly oblique nerves of the lumbosacral plexus (LSP). The present study introduces a T2 mapping sequence (T2-prepared 3D turbo spin echo) that is B1-insensitive and enables quantitative assessment of LSP nerves.
In this study 15 healthy subjects (mean age 28.

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Jan
2018

To present treatment strategies for spinal extradural arteriovenous fistulas (AVFs) in relation to angioarchitecture.
A retrospective analysis comprising 14 patients treated at 2 hospitals was performed.
The 14 AVFs included 4 cervical, 1 thoracic, and 9 lumbosacral lesions.

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Oct
2017

The lumbosacral trunk, typically comprised of part of the fourth lumbar ventral rami and the entirety of the fifth lumbar ventral rami, serves as a connection between the lumbar and sacral plexuses. Developmental differences underlie the variable relative contributions of L4 and L5 to the lumbosacral trunk. Herein, we report a rare case in which dissection of an adult male cadaver revealed no L4 contribution to the lumbosacral plexus.

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Dec
1969

Sepsis-induced neuromuscular dysfunction results from up-regulation of the expression of γ- and α7-nicotinic acetylcholine receptors (nAChR). Although glial cell derived neurotrophic factor (GDNF) has been implicated in repairing and supporting neurons, little is known about the effects of GDNF on demyelination of nerves in sepsis. In this study, we tested the hypothesis that GDNF could alleviate sepsis-induced neuromuscular dysfunction by decreasing the expression of γ- and α7-nAChR in an experimental rat model of neuromyopathy.

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Dec
1969

Plexus and peripheral nerve metastasis.

Handb Clin Neurol 2018 ;149:257-279
Kelly G Gwathmey
Cancer in the form of solid tumors, leukemia, and lymphoma can infiltrate and metastasize to the peripheral nervous system, including the cranial nerves, nerve roots, cervical, brachial and lumbosacral plexuses, and, rarely, the peripheral nerves. This review discusses the presentation, diagnostic evaluation, and treatment options for metastatic lesions to these components of the peripheral nervous system and is organized based on the anatomic distribution. As skull base metastases (also discussed in Chapter 14) result in cranial neuropathies, these will be covered in detail, as well as cancers that directly infiltrate the cranial nerves.

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Mar
2018

Perineural spread (PNS) of pelvic cancer along the lumbosacral plexus is an emerging explanation for neoplastic lumbosacral plexopathy (nLSP) and an underestimated source of patient morbidity and mortality. Despite the increased incidence of PNS, these patients are often times a clinical conundrum-to diagnose and to treat. Building on previous results in modeling glioblastoma multiforme (GBM), we present a mathematical model for predicting the course and extent of the PNS of recurrent tumors.

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Dec
1969

The course of the superior gluteal artery (SGA) as it passes through the lumbosacral plexus is variable. The variations of the arterial course in relation to the lumbosacral plexus have focused on statistical analysis, and it is limited arterial diversity. In this study, we investigated the positional relation between the SGA and the furcal nerve (FN): guide to segmentation of the lumbosacral plexus, arising from the L4, ie, the contribution to the femoral nerve, obturator nerve, and lumbosacral trunk.

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Dec
2017

Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladder triangle. Based on this theoretical knowledge, we formed a hypothesis that CRBD could be prevented by pudendal nerve block.

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Dec
2017

To observe the effect of the expressive or functional blockage of TRPV1 on nerve regeneration after sciatic trans-section injury.AMG-517, a kind of TRPV1 inhibitor, was injected into the surrounding area of the ipsilateral lumbar dorsal root ganglia while unilateral sciatic nerve was transected. A total of 24 healthy male Sprague-Dawley rats were divided into 4 groups: control group, injury only group, injury+ AMG-517 150 μg/kg group, injury+ AMG-517 300 μg/kg group.

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Dec
2017

To observe the possibility of posterior approach via sacrectomy for reaching intrapelvic sacral plexus and expose the deep intrapelvic origin of sciatic nerve from sacral plexus in order to perform nerve graft.Five adult cadaver specimens were used in the study with prone position in May 2012. Cut off the gluteus maximus along the origins and lift to the lateral side, the piriformis was lay beneath.

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Jan
2018

There is a paucity of real-world data regarding surgeon utilization of sacral nerve stimulation for fecal incontinence compared with anal sphincteroplasty.
This study aims to examine trends in sacral nerve stimulation use compared with sphincteroplasty for fecal incontinence and surgeon-level variation in progression to implantation of the pulse generator.
This is a population-based study.

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Dec
1969

The transversus abdominis plane block is a regional anesthesia technique that has become popular. Being a relatively simple procedure, the TAP block has an excellent safety profile and major complications are rare. We present a case of transient femoral nerve palsy occurring after a TAP block with involvement of the sacral plexus for a patient who had undergone a caesarean section.

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Dec
1969

Sciatic and femoral nerve blocks (SNB and FNB) result in effective lower limb analgesia. Classical SNB and FNB require patient repositioning which can cause pain and discomfort. Alternative approaches to sciatic and femoral nerve blocks in supine patients can be useful.

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Feb
2018

A profound reduction in colorectal transit time accompanies spinal cord injury (SCI), yet the colonic alterations after SCI have yet to be understood fully. The loss of descending supraspinal input to lumbosacral neural circuits innervating the colon is recognized as one causal mechanism. Remodeling of the colonic enteric nervous system/smooth muscle junction in response to inflammation, however, is recognized as one factor leading to colonic dysmotility in other pathophysiological models.

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Feb
2018

Neurolymphomatosis is a neurologic complication poorly recognized by neurologists and oncologists and presents usually several months after successful treatment of systemic lymphoma. Other disorders that must be differentiated from these entities include peripheral-nerve or nerve root compression and paraneoplastic neuropathy.
To describe the unusual occurrence of neurolymphomatosis in a patient of B-cell lymphoma.

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Feb
2018

Charcot-Marie-Tooth (CMT) disease is clinically and genetically heterogeneous. There are no published series describing clinical, electrophysiological, and genetic information on CMT from the Indian subcontinent. Magnetic resonance imaging (MRI) neurography technique provides useful information about the plexus and roots and can be employed in patients with CMT.

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Dec
2017

Most of the literature concerning the neurocutaneous flap is related to its anatomic investigation and clinical application, and the more in-depth physiological problem such as whether the cutaneous nerve contains sympathetic fibers that innervate its accompanying vessels has never been explored.
Dissection was first performed on three rabbits. In another 22 rabbits, two rabbits undergoing no surgery were used as the normal control group.

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Nov
2017

This study aims to investigate the effect of a somatosensory cueing on gait disorders in subjects with Parkinson's disease (PD). After having performed stepping in place and timed up and go assessing tasks, 13 participants with PD were equipped with an electrical stimulator and an inertial measurement unit (IMU) located under the lateral malleolus on the sagittal plane. Electrodes were positioned under the arch of the foot and electrical stimulation (ES) parameters (five 500 µs/phase charge-balanced biphasic pulses delivered at 200 Hz, repeated four times at 10 Hz) adjusted to deliver a sensitive signal.

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Sep
2017

Pelvic fracture is one of the common diseases of traumatic orthopedics. With the increase of accidents such as traffic accidents,high craters and crush injuries in China,the incidence of pelvic fractures is also increasing year by year. Since pelvic bones and the ligament structure are close to neurovascular,cavity organs and the urogenital structure,early diagnosis and treatment of pelvic fractures is essential for preventing early complications and late sequelae.

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Dec
1969

Peripheral nerve repair is still challenging for surgeons. Autologous nerve transplantation is the acknowledged therapy; however, its application is limited by the scarcity of available donor nerves, donor area morbidity, and neuroma formation. Biomaterials for engineering artificial nerves, particularly materials combined with supportive cells, display remarkable promising prospects.

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Dec
2017

Decision-making for pulse generator implantation for sacral nerve stimulation in the management of fecal incontinence is based on the results of a test phase. Its duration is still a matter of debate.
The purpose of this study was to determine whether an early positive response during the test phase could predict implantation of a permanent sacral nerve pulse generator.

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Dec
2017

Schwann cell c-Jun is implicated in adaptive and maladaptive functions in peripheral nerves. In injured nerves, this transcription factor promotes the repair Schwann cell phenotype and regeneration and promotes Schwann-cell-mediated neurotrophic support in models of peripheral neuropathies. However, c-Jun is associated with tumor formation in some systems, potentially suppresses myelin genes, and has been implicated in demyelinating neuropathies.

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Dec
2017

Healthy subjects can learn to use cognitive-emotional strategies to suppress their spinal nociception, quantified by the nociceptive flexor reflex (RIII reflex), when given visual RIII feedback. This likely reflects learned activation of descending pain inhibition. Here, we investigated if training success persists 4 and 8 months after the end of RIII feedback training, and if transfer (RIII suppression without feedback) is possible.

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Dec
2017

Schwann cells (SCs) are myelinating cells of the PNS. Although SCs are known to express different channels and receptors on their surface, little is known about the activation and function of these proteins. Ionotropic glutamate receptors are thought to play an essential role during development of SC lineage and during peripheral nerve injury, so we sought to study their functional properties.

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Oct
2017

To investigate the clinical outcomes of posterior laminectomy on intraspinal neurilemmoma. Twenty-seven patients with intraspinal neurilemmoma admitted to the Second People's Hospital of Changzhou Affiliated to Nanjing Medical University from January 2010 to October 2015 were selected, and they received posterior laminectomy, and there were 5 patients whose nerve root and tumor were removed together because they could not be separated; 17 patients receiving total laminectomy or semi-laminectomy combined with facetectomy on the affected side were treated with spinal dynamic pedicle screw fixation or replantation of lamina or bone graft fusion and internal fixation. The patients were followed up regularly to observe the clinical outcomes after operation.

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Oct
2016

To observe the efficacy of acupuncture stimulation of the sciatic nerve trunk in the treatment of patients suffering from sciatica induced by lumbar disc herniation (LDH).
A total of 60 LDH sciatica patients met the inclusion criteria were randomly divided into treatment group and control group, with 30 cases in each. Patients of the treatment group were treated by directly needling the sciatic nerve and routine acupuncture of-points, Lumbar Jiaji (EX-B 2), Dachangshu (BL 28), etc.

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Oct
2017

Lippia sidoides Cham is a typical herb species of Northeast Brazil with widespread use in folk medicine. The major constituents of the essential oil of L. sidoides (EOLs) are thymol, p-cymene, myrcene, and caryophyllene.

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Oct
2017

To evaluate inter-reader performance for cross-sectional area and fat quantification of bilateral sciatic nerves on MRI and assess correlations with anthropometrics.
In this IRB-approved, HIPPA-compliant study, three readers performed a cross-sectional analysis of 3T lumbosacral plexus MRIs over an 18-month period. Image slices were evaluated at two levels (A and B).

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Dec
1969

JMJD2A is a JmjC histone demethylase that catalyzes the demethylation of di- and trimethylated Lys9 and Lys36 in histone H3 (H3K9me2/3 and H3K36me2/3). The role of spinal JMJD2A-dependent histone demethylation in nociception hypersensitivity development remains elusive. Here we reported that the JMJD2A responded to neuropathic pain and participated in the maintenance of neuropathic pain.

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Oct
2017

Retrospective clinical case series.
To study the role of MRN of lumbosacral plexus in management of patients with FBSS.
Failed back surgery syndrome (FBSS) is one of the major problems in health care, affecting up to 40% of patients following spine surgery.

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Jan
2018

Controlled delivery of multiple therapeutic agents can be considered an effective approach in nerve injury due to its multifunction. In this study, recombinant human vascular endothelial growth factor (VEGF) and recombinant human nerve growth factor (NGF) were loaded on the surface and in the core of emulsion electrospun poly (l-lactic acid) (PLLA) nanofibrous scaffold, respectively. The in vitro studies showed that VEGF and NGF had a sequential release pattern in which most of the VEFG was released in the first few days but the NGF could be continuously released for >1month.

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Nov
2017

To detect and quantify peripheral nerve lesions in multiple sclerosis (MS) by magnetic resonance neurography (MRN).
Thirty-six patients diagnosed with MS based on the 2010 McDonald criteria (34 with the relapsing-remitting form, 2 with clinically isolated syndrome) with and without disease-modifying treatment were compared to 35 healthy age-/sex-matched volunteers. All patients underwent detailed neurological and electrophysiological examinations.

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Dec
1969

Peripheral neurotoxicity is one of the most distressing side effects of oxaliplatin therapy for cancer. Indeed, most patients that received oxaliplatin experience acute and/or chronic severe sensory peripheral neuropathy. However, despite similar co-morbidities, cancer stage, demographics and treatment schedule, patients develop oxaliplatin-induced peripheral neurotoxicity with remarkably different severity.

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Sep
2017

To evaluate three different kinds of neurorrhaphy of the peroneal nerve.
Eigthy rats were divided into 5 groups. Control: nerve had no intervention.

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Dec
1969

Fossils are almost always represented by hard tissues but we present here the exceptional case of a three-dimensionally preserved specimen that was 'mummified' (likely between 40 and 34 million years ago) in a terrestrial karstic environment. This fossil is the incomplete body of a salamander,, whose skeleton and external morphology are well preserved, as revealed by phase-contrast synchrotron X-ray microtomography. In addition, internal structures composed of soft tissues preserved in three dimensions are now identified: a lung, the spinal cord, a lumbosacral plexus, the digestive tract, muscles and urogenital organs that may be cloacal glands.

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Nov
2017

To simulate sacrospinous ligament fixation on cadaveric specimens, describe the surrounding retroperitoneal anatomy, and estimate the risk to nerves and arteries for the purposes of optimizing safe suture placement.
Sacrospinous ligament fixation was performed on eight fresh-tissue female cadavers using a Capio ligature capture device. Distances from placed sutures to the following structures were measured: ischial spine; fourth sacral root; pudendal nerve; the nerve to coccygeus muscle; the nerve to levator ani muscle; inferior gluteal artery; and internal pudendal artery.

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Dec
2017

OBJECTIVE Over the last decade, a number of authors have investigated the utility of different biological and synthetic matrices as alternatives to conventional nerve grafts. However, the autologous nerve graft remains the gold standard, even though it often involves using a pure sensory nerve to reconstruct a mixed or even a pure motor nerve. Furthermore, limited donor sites often necessitate a significant mismatch of needed nerve tissue, especially for large proximal nerve defects such as brachial plexus lesions.

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Oct
2017

This is the first study demonstrating the efficacy of menstrual blood-derived stem cell (MenSC) transplantation via a neural guidance conduit, for peripheral nerve regeneration. The synthesized poly (ɛ-caprolactone)/Gelatin conduit, filled with collagen type I and seeded with 3 × 10MenSCs, was implanted into a rat's 10 mm sciatic nerve defect. The results of hot plate latency, sciatic functional index and weight-loss percentage of wet gastrocnemius muscle demonstrated that the MenSC transplantation had comparable nerve regeneration outcome to autograft, as the gold standard of nerve bridging.

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