Laparoscopic Dissection and Anatomy of Sacral Nerve Roots and Pelvic Splanchnic Nerves

2014 ◽  
Vol 21 (6) ◽  
pp. 982-983 ◽  
Author(s):  
Alysson Zanatta ◽  
Mateus M. Rosin ◽  
Ricardo L. Machado ◽  
Leonardo Cava ◽  
Marc Possover
2013 ◽  
Vol 20 (6) ◽  
pp. S64
Author(s):  
A. Zanatta ◽  
M.M. Rosin ◽  
R.L. Machado ◽  
L. Cava ◽  
M. Possover

2010 ◽  
Vol 76 (3) ◽  
pp. 253-262 ◽  
Author(s):  
Petros Mirilas ◽  
John E. Skandalakis

We present surgicoanatomical topographic relations of nerves and plexuses in the retroperitoneal space: 1) six named parietal nerves, branches of the lumbar plexus: iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral. 2) The sacral plexus is formed by the lumbosacral trunk, ventral rami of S1–S3, and part of S4; the remainder of S4 joining the coccygeal plexus. From this plexus originate the superior gluteal nerve, which passes backward through the greater sciatic foramen above the piriformis muscle; the inferior gluteal nerve also courses through the greater sciatic foramen, but below the piriformis; 3) sympathetic trunks: right and left lumbar sympathetic trunks, which comprise four interconnected ganglia, and the pelvic chains; 4) greater, lesser, and least thoracic splanchnic nerves (sympathetic), which pass the diaphragm and join celiac ganglia; 5) four lumbar splanchnic nerves (sympathetic), which arise from lumbar sympathetic ganglia; 6) pelvic splanchnic nerves (nervi erigentes), providing parasympathetic innervation to the descending colon and pelvic splanchna; and 7) autonomic (prevertebral) plexuses, formed by the vagus nerves, splanchnic nerves, and ganglia (celiac, superior mesenteric, aorticorenal). They include sympathetic, parasympathetic, and sensory (mainly pain) fibers. The autonomic plexuses comprise named parts: aortic, superior mesenteric, inferior mesenteric, superior hypogastric, and inferior hypogastric (hypogastric nerves).


2020 ◽  
Vol 136 ◽  
pp. 208-212 ◽  
Author(s):  
Nathaniel Melling ◽  
Pasquale Scognamiglio ◽  
Sven Teller ◽  
Jakob Robert Izbicki ◽  
Marc Dreimann ◽  
...  

2018 ◽  
Vol 25 (7) ◽  
pp. S88
Author(s):  
A.L. Li ◽  
L. Cancelliere ◽  
I. Marcu ◽  
G.L. Fernandes ◽  
C. Sermer ◽  
...  

1991 ◽  
Vol 32 (3) ◽  
pp. 210-213 ◽  
Author(s):  
John K. Hald ◽  
P. H. Nakstad ◽  
B. E. Hauglum
Keyword(s):  

2009 ◽  
Vol 11 (3) ◽  
pp. 255-263 ◽  
Author(s):  
Erik F. Hauck ◽  
Markus Schwefer ◽  
Werner Wittkowski ◽  
Hans W. Bothe

Object The study aims to analyze nerve fiber types in the sacral nerve roots as a prerequisite for stimulation. Methods One-micrometer cross-sections of human ventral and dorsal S1–5 roots were stained with osmium and toluidine blue. The total fiber diameter and myelin sheath were measured in 282,420 nerve fibers. Results The analysis revealed the following 3 main nerve fiber types: Aα fibers (diameter 6–14 μm), Aγ fibers (diameter 2–4 μm), and B fibers (diameter < 2 μm). The B fibers were absent in S-1, present in some S-2 fascicles, and abundant from S-3 to S-5. The Aα fibers dominated the S-1 roots and most fascicles of S-2 roots. In the S3–5 roots, only a few Aα fibers were present. The relative occurrence of Aγ fibers increased from S-1 to S-5. In dorsal roots, Aγ fibers represented ~ 70% of all nerve fibers in every root and fascicle. Conclusions The B fibers represented efferent parasympathetic fibers. These fibers were concentrated in certain areas of the nerve roots, not randomly distributed. The Aα fibers innervate lower-extremity muscles and sphincters. The inverse correlation of Aα and Aγ fibers in the ventral roots from S-1 to S-5 is surprising. In dorsal roots, Aγ fibers may conduct pain, touch, and temperature signals. Highly selective fiber stimulation specific for type, location, and direction may improve sacral nerve stimulation for a spastic bladder in paraplegic individuals.


2004 ◽  
Vol 23 (3) ◽  
pp. 241-245 ◽  
Author(s):  
J.A. Bycroft ◽  
M.D. Craggs ◽  
M. Sheriff ◽  
S. Knight ◽  
P.J.R. Shah

Neurosurgery ◽  
1979 ◽  
Vol 4 (6) ◽  
pp. 521-523 ◽  
Author(s):  
Hector E. James ◽  
John J. Mulcahy ◽  
John W. Walsh ◽  
George W. Kaplan

abstract The mechanical activity of the anal sphincter can be translated into electrical activity and recorded on graph paper or an oscilloscope. The activity of the anal sphincter may be extrapolated to activity of the external urethral sphincter because both are striated muscles innervated by the pudendal nerve that arises from S-2, S-3, and S-4. Stimulation of these nerves causes contraction of the sphincter muscles, and a deflection of the recording device occurs. This technique was employed intraoperatively in monitoring operations on the conus medullaris and sacral nerve roots in 10 patients with spinal dysraphism (age range, 3 weeks to 15 years). Their diagnoses were tethered conus, 4; lipomeningocele, 3; spinal hamartoma, 1; syringocele, 1; and sacral arachnoiditis, 1. With general anesthesia, and the patient in the prone position, an electrode-containing anal plug was inserted or two needle electrodes were inserted into the anal sphincter muscle. The electrodes were connected to the electromyography recording stylus of the urodynamic bladder diagnostic unit. During the spinal operation, whenever a structure could not be identified clearly, it was stimulated with the disposable electrical stimulator and, if oscillations of the stylus occurred (indicating contraction of the anal sphincter), the structure was preserved. This technique permitted spinal operations in these 10 patients without changes in neurological or urological function.


2008 ◽  
Vol 20 (10) ◽  
pp. 1132-1139 ◽  
Author(s):  
m. l. harris ◽  
s. singh ◽  
j. rothwell ◽  
d. g. thompson ◽  
s. hamdy

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