Peripheral Nerve Ultrasound: from Clinic to Operating Room

Author(s):  
Aadithya Rangarajan ◽  
Lokesh Bathala ◽  
Madhusudan Gururajrao ◽  
M. S. Mahesh ◽  
Man Mohan Mehndiratta
Neurosurgery ◽  
2010 ◽  
Vol 66 (4) ◽  
pp. 784-787 ◽  
Author(s):  
Philipp Slotty ◽  
Patrick Kröpil ◽  
Mark Klingenhöfer ◽  
Hans-Jakob Steiger ◽  
Daniel Hänggi ◽  
...  

Abstract OBJECTIVE Exact intraoperative localization of pathologies in spinal and peripheral nerve surgery is not easily achieved. In spinal surgery, intraoperative fluoroscopy is the common method for identification of the level affected. It seldom visualizes the pathology itself and is prone to error in identifying anatomic disorders and superimposing structures. In peripheral nerve surgery, intraoperative fluoroscopy is of little value. The present technical study was conducted to evaluate the feasibility of using a preoperative computed tomography–guided needle marking system, which was previously developed for use in gynecology. The goal was to reduce intraoperative localization error and radiation exposure to patients and operating room personnel. METHODS We used a flexible hooked-wire needle marking system, which has previously been used for preoperative marking of breast lesions, to localize and tag spinal and peripheral nerve pathologies. Marking was carried out under computed tomographic control before surgery. Seven illustrative cases were chosen for this report: 6 patients with disorders of the spine and 1 patient with a peripheral nerve schwannoma. RESULTS No adverse reactions, aside from minor discomfort, were observed in this study. In all cases, the needle could be used as a reliable guide for the surgical approach and led directly to the pathology. In no case was additional intraoperative fluoroscopy needed. The level of radiation exposure to the patient as a result of computed tomography–based marking was similar to or less than that encountered in conventional intraoperative x-ray localization. Radiation exposure to the operating room personnel was eliminated by this method. CONCLUSION Preoperative marking of spinal level or peripheral nerve pathologies with a flexible hooked-wire needle marking system is feasible and appears to be safe and useful for neurosurgical spinal and peripheral procedures.


2015 ◽  
pp. 33-33
Author(s):  
Kay Ng ◽  
Aravinda Therimadasamy ◽  
Li Eileen ◽  
Einar Wilder-Smith

2016 ◽  
Vol 35 (6) ◽  
pp. 1367-1368
Author(s):  
Jonathan K. Smith ◽  
Matthew E. Miller ◽  
David E. Reece ◽  
Yin-Ting Chen ◽  
Mark E. Landau

2016 ◽  
Vol 264 (2) ◽  
pp. 243-253 ◽  
Author(s):  
Alexander Grimm ◽  
Tim W. Rattay ◽  
Natalie Winter ◽  
Hubertus Axer

2018 ◽  
Vol 129 ◽  
pp. e167-e168
Author(s):  
Eoin Mulroy ◽  
Luciana Pelosi ◽  
Ruth Leadbetter ◽  
Purwa Joshi ◽  
Miriam Rodrigues ◽  
...  

2015 ◽  
Vol 126 (8) ◽  
pp. e75
Author(s):  
A. Grimm ◽  
B. Décard ◽  
H. Axer

2016 ◽  
Vol 127 (2) ◽  
pp. 1652-1656 ◽  
Author(s):  
Siti Nur Omaira Razali ◽  
Thaarani Arumugam ◽  
Nobuhiro Yuki ◽  
Faizatul Izza Rozalli ◽  
Khean-Jin Goh ◽  
...  

2018 ◽  
Vol 20 (2) ◽  
pp. 255 ◽  
Author(s):  
Nicola Romano ◽  
Jeries Paolo Zawaideh ◽  
Aldo Fischetti ◽  
Caterina Lapucci ◽  
Sergio Gennaro ◽  
...  

A 22 years-old-man was admitted to emergency after trauma. He suffered multiple deep cuts on his left leg. A lesion of the ischiatic nerve was suspected, and an ultrasound (US) evaluation was requested to confirm it. The study was conducted in the emergency room using a linear ultrasound transducer of 6-15 MHz and demonstrated the completely truncation of the ischiatic nerve (neurotmesis - Sunderland Grade V) with the proximal end retracted up to about 3cm from the edge of the wound. It was a very useful information for the neurosurgeon who after performed an end-to-end neurorrhaphy with suturation of perineurium. This short report underlines the importance of US, that thanks to its high spatial resolution and its time- and cost-effectiveness, can be considered a very important tool for the physician in emergency room to characterize peripheral nerve lesions.


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