Acute immune sensory dominant polyradiculopathy predominantly involving thoracic nerve roots

2021 ◽  
Author(s):  
Woojun Kim ◽  
Jae Young An
Keyword(s):  
Nerve Roots ◽  
Thoracic Nerve

The projection of the thoracic nerve roots and their connection with intervertebral discs: a cadaver and radiological study

2019 ◽  
Vol 61 (8) ◽  
pp. 1050-1056
Author(s):  
Chao Jiang ◽  
Qiang Guo ◽  
Ze-Ming Sun ◽  
Ze-Xin Chen ◽  
Jia-Jing Xu ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine ◽  
Sagittal Plane ◽  
Intervertebral Discs ◽  
Posterolateral Approach ◽  
Nerve Roots ◽  
Anatomical Features ◽  
Thoracic Nerve ◽  
Dural Sac ◽  
Transforaminal Endoscopic Surgery

Background The anatomical features of the thoracic nerve roots in connection with intervertebral discs may prevent surgery-related complications and improve patients’ neurological functional status during thoracic spine surgery. There is limited literature evidence regarding this concept using cadavers. Purpose To elucidate the qualitative anatomical features of the thoracic nerve roots in connection with intervertebral discs. Material and Methods Fifteen formalin-preserved spine specimens were used in this study. Small pieces of stainless-steel wires were placed along the root sleeves from their points of origin, after exposing the dural sac and bilateral nerve roots. The standard anteroposterior and lateral radiographs were taken after the placement of the wires. Measurements were done on radiographs using the picture archiving communication system. Results Take-off angles of the nerve roots at the coronal plane gradually increased from the level of T2 (36.1°±2.72°) to T9 (84.1°±1.84°) and from T9, it decreased to T12 (46.3° ± 2.67°). Similar variation tendency was discovered in take-off angles of the nerve roots at the sagittal plane. No consistent tendency was found both in the distance from the origin of the root sleeve to its superior and inferior vertebral endplate. Distance from the origin of the root sleeve to the posterior midline (DM) exponentially decreased from T1 (8.2 ± 0.87 mm) to T4 (6.0 ± 0.93 mm). It slowly increased from T5 (5.5 ± 0.68 mm) to T12 (10.9 ± 1.79 mm), with T5 having the smallest DM. Distance between the origins of neighboring nerve roots showed an obvious increase from the T1–T2 interval (23.1 ± 2.22 mm) to T7–T8 interval (30.9 ± 2.68 mm). However, it progressively decreased at the T10–T11 interval (26.0 ± 2.40 mm). Conclusion The dimensions of the thoracic nerve roots vary greatly from T1 to T12 intervertebral discs. Sound knowledge of these anatomical features of the thoracic nerve is mandatory for the thoracic spine surgery, especially in the posterolateral approach and transforaminal endoscopic surgery.

scholarly journals Effect of Radiofrequency Thermocoagulation of Thoracic Nerve Roots in Patients with Cancer and Intractable Chest Wall Pain

2018 ◽  
Vol 1 (21;1) ◽  
pp. E323-E329
Author(s):  
Dae Hyun Kim
Keyword(s):  
Radiofrequency Ablation ◽  
Chest Wall ◽  
Nerve Root ◽  
Cancer Center ◽  
Primary Cancer ◽  
Nerve Roots ◽  
Patients With Cancer ◽  
Thoracic Nerve ◽  
Post Procedure ◽  
Radiofrequency Thermocoagulation

Background: Interventional pain management is essential for patients with cancer who experience medically uncontrollable chest wall pain to help control their symptoms and improve their quality of life. However, there is a lack of data on this topic, so there is an urgent need for further research. Objectives: To identify the effects of radiofrequency ablation (RFA) of the thoracic nerve roots on pain outcomes in patients with cancer and intractable chest wall pain. Study Design: Retrospective, observational cohort study. Setting: National Cancer Center in Korea. Methods: The medical records of patients with cancer who were referred to the pain clinic at our National Cancer Center for intractable chest wall pain and who underwent thoracic nerve root RFA between Jan. 1, 2011 and Dec. 31, 2015 were analyzed. The primary outcome was the change in Numeric Rating Scale (NRS) scores between pre-procedure and one week, one month, and 6 months post-procedure. The secondary outcomes were the change in morphine equivalent daily dose (MEDD) between pre-procedure and one week, one month, and 6 months post-procedure, and whether the primary cancer type (lung vs. non-lung) or radiotherapy to the chest within one month affected the outcomes of RFA. The Wilcoxon signed-rank test was used to compare RFA data between pre and post-procedure and P values less than 0.05 were considered statistically significant. Results: One hundred patients were included in the final analysis. The median NRS score in patients who underwent RFA decreased from 7 (range 3–10) pre-procedure to 4 (0–9) at one week and one-month post-procedure (both P < 0.001) and 4 (1–8) at 6 months post-procedure (P < 0.001). The median MEDD value decreased from 200 (range 30–1800) mg pre-procedure to 180 (10–1600) mg at one week post-procedure (P < 0.001), but there was no statistically significant change at one month (P = 0.699) or 6 months (P = 0.151) post-procedure. There was no difference in RFA outcome according to type of primary cancer or radiotherapy to the chest within one month. Limitations: Retrospective design. Conclusion: Radiofrequency thermocoagulation of the thoracic nerve roots achieved effective short-term pain control in patients with cancer and intractable chest wall pain. Key words: Radiofrequency ablation, thermocoagulation, thoracic nerve root, cancer, chest wall pain, radiotherapy, pain relief

Simulation of Cough in Man by Magnetic Stimulation of the Thoracic Nerve Roots

1997 ◽  
Vol 156 (5) ◽  
pp. 1696-1699 ◽  
Author(s):  
D. KYROUSSIS ◽  
M. I. POLKEY ◽  
G. H. MILLS ◽  
P. D. HUGHES ◽  
J. MOXHAM ◽  
...  
Keyword(s):  
Magnetic Stimulation ◽  
Nerve Roots ◽  
Thoracic Nerve ◽  
Stimulation Of

Thoracic Epidural and Nerve Root Injections: Fluoroscopy

2016 ◽  
Author(s):  
Jianguo Cheng
Keyword(s):  
Nerve Root ◽  
Small Volume ◽  
Epidural Block ◽  
Nerve Roots ◽  
Nerve Root Block ◽  
Thoracic Epidural ◽  
Thoracic Nerve ◽  
Transforaminal Approach ◽  
Nerve Root Blocks ◽  
Selective Nerve Root Block

Thoracic nerve root blocks can be achieved by interlaminal epidural, transforaminal epidural, paravertebral, and selective nerve root injections. The interlaminal approach allows blocking multiple nerve roots bilaterally, while the transforaminal approach has the advantage of depositing the injectate primarily to the anterior epidural space on the side of the injection, closer to the pathology. The paravertebral approach is often used to block multiple nerve roots on the side of injection, and the selective nerve root block is used to target a specific nerve root using a small volume of injectate. Fluoroscopy-guided injection the most commonly used technique. Contrast materials are often used to confirm the appropriate needle placement and monitor the spread of the injectate. Thoracic nerve root block and transforaminal epidural block are perceived as technically demanding due to anatomic complexity of the thoracic spine, its proximity to the lungs and major vasculature, and potential complications.

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