25. Neurophysiological detection of iatrogenic C5 nerve root injury during anterior cervical laminectomy and laminoplasty

2004 ◽  
Vol 4 (5) ◽  
pp. S15-S16
Author(s):  
Bikash Bose ◽  
Anthony Sestokas ◽  
Daniel Schwartz
Keyword(s):  
Nerve Root ◽  
Nerve Root Injury ◽  
Cervical Laminectomy ◽  
Root Injury

scholarly journals The Effectiveness and Safety of Ultrasonic Bone Scalpel Versus Conventional Method in Cervical Laminectomy: A Retrospective Study of 311 Patients

2019 ◽  
Vol 10 (6) ◽  
pp. 760-766
Author(s):  
Bharat R. Dave ◽  
Ajay Krishnan ◽  
Ravi Ranjan Rai ◽  
Devanand Degulmadi ◽  
Shivanand Mayi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Conventional Method ◽  
Nerve Root ◽  
Surgical Complications ◽  
Nerve Root Injury ◽  
Cervical Laminectomy ◽  
C5 Palsy ◽  
Root Injury ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Study Design: Retrospective cohort study. Objectives: The aim of this study was to compare the results of cervical laminectomy (CL) performed with ultrasonic bone scalpel (UBS) or conventional method (CM). Method: This study comprised 311 CL performed by a single surgeon between January 2004 and December 2017. Group A (GpA) comprised 124 cases of CL performed using UBS, while Group B (GpB) comprised 187 cases of CL performed using CM. These 2 groups were compared in terms of demographic characteristics of patients, duration of surgery, estimated blood loss, and surgical complications. Results: GpA included 112 males and 12 females, mean age being 61.18 years. GpB comprised 166 males and 21 females, mean age being 62.04 years. Mean duration of surgery, estimated blood loss, and length of hospital stay was 65.52/70.87 minutes, 90.24/98.40 mL, and 4.80/4.87 days in GpA and GpB, respectively. Six patients were reported to have dural injuries in each group. In GpA, 2 cases of C5 palsy and 1 nerve root injury was observed, while in GpB, 3 cases of C5 palsy and no nerve root injury was reported. One patient had developed transient neurological deterioration postsurgery in GpA as against 11 patients in GpB. Conclusion: Neurological complications observed in CM leads to intensive care unit admission, additional morbidity, and additional expenditure, whereas UBS provides a safe, rapid, and effective means of performing CL, thereby decreasing the rate of surgical complications and postoperative morbidity.

Rating Spinal Nerve Extremity Impairment Using the Sixth Edition

2009 ◽  
Vol 14 (4) ◽  
pp. 1-6
Author(s):  
Christopher R. Brigham
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Upper Extremities ◽  
Motor Deficits ◽  
Nerve Injuries ◽  
Sixth Edition ◽  
Federal Employee ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Rating Process

Abstract The AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, does not provide a separate mechanism for rating spinal nerve injuries as extremity impairment; radiculopathy was reflected in the spinal rating process in Chapter 17, The Spine and Pelvis. Certain jurisdictions, such as the Federal Employee Compensation Act (FECA), rate nerve root injury as impairment involving the extremities rather than as part of the spine. This article presents an approach to rate spinal nerve impairments consistent with the AMA Guides, Sixth Edition, methodology. This approach should be used only when a jurisdiction requires ratings for extremities and precludes rating for the spine. A table in this article compares sensory and motor deficits according to the AMA Guides, Sixth and Fifth Editions; evaluators should be aware of changes between editions in methodology used to assign the final impairment. The authors present two tables regarding spinal nerve impairment: one for the upper extremities and one for the lower extremities. Both tables were developed using the methodology defined in the sixth edition. Using these tables and the process defined in the AMA Guides, Sixth Edition, evaluators can rate spinal nerve impairments for jurisdictions that do not permit rating for the spine and require rating for radiculopathy as an extremity impairment.

Cervical Ganglia and Nerve Root Injury: Evidence for Respiratory Arrest as Initiating Injury in Pediatric Head Trauma

2014 ◽  
Vol 4 (4) ◽  
pp. 514-519
Author(s):  
Mary Ann Sens ◽  
Sarah E. Meyers ◽  
Mark A. Koponen ◽  
Arne H. Graff ◽  
Ryan D. Reynolds ◽  
...  
Keyword(s):  
Head Trauma ◽  
Nerve Root ◽  
Respiratory Arrest ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Pediatric Head Trauma ◽  
Cervical Ganglia

scholarly journals Triple Conjoined Nerve Root—An Unreported Anatomical Variant and Its Surgical Implications

2020 ◽  
Vol 9 (03) ◽  
pp. 215-218
Author(s):  
Kelly Gassie ◽  
Krishnan Ravindran ◽  
Gazanfar Rahmathulla ◽  
H. Gordon Deen
Keyword(s):  
Nerve Root ◽  
Root Anatomy ◽  
Neurological Injury ◽  
Herniated Disc ◽  
Anatomical Variant ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Conjoined Nerve Roots ◽  
High Degree ◽  
Conjoined Nerve Root

AbstractConjoined nerve roots are an infrequent and uncommon finding, rarely noted preoperatively. The conjoined root anomaly has potential for significant neurological injury during surgery. Preoperative recognition may avert disastrous nerve root injury but requires a high degree of clinical suspicion. We present the case of a 44-year-old patient with left L5/S1 radiculopathy caused by a herniated disc. During surgery we identified a triple conjoined nerve root anatomy. This anatomical variant, to our knowledge, has not been reported in literature. We describe the anatomical findings and surgical implications.

scholarly journals The potential for salmon fibrin and thrombin to mitigate pain subsequent to cervical nerve root injury

Biomaterials ◽  
2011 ◽  
Vol 32 (36) ◽  
pp. 9738-9746 ◽  
Author(s):  
Christine L. Weisshaar ◽  
Jessamine P. Winer ◽  
Benjamin B. Guarino ◽  
Paul A. Janmey ◽  
Beth A. Winkelstein
Keyword(s):  
Nerve Root ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Nerve Root Injury ◽  
Root Injury

scholarly journals Feasibility of Using Intraoperative Neuromonitoring in the Prophylaxis of Dysesthesia in Transforaminal Endoscopic Discectomies of the Lumbar Spine

2020 ◽  
Vol 10 (8) ◽  
pp. 522
Author(s):  
Paulo Sérgio Teixeira de Carvalho ◽  
Max Rogério Freitas Ramos ◽  
Alcy Caio da Silva Meireles ◽  
Alexandre Peixoto ◽  
Paulo de Carvalho ◽  
...  
Keyword(s):  
Nerve Root ◽  
Statistical Power ◽  
Motor Evoked Potentials ◽  
Lumbar Disc ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Control Group ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Sensory Evoked

(1) Background: Postoperative nerve root injury with dysesthesia is the most frequent sequela following lumbar endoscopic transforaminal discectomy. At times, it may be accompanied by transient and rarely by permanent motor weakness. The authors hypothesized that direct compression of the exiting nerve root and its dorsal root ganglion (DRG) by manipulating the working cannula or endoscopic instruments may play a role. (2) Objective: To assess whether intraoperative neurophysiological monitoring can help prevent nerve root injury by identifying neurophysiological events during the initial placement of the endoscopic working cannula and the directly visualized video endoscopic procedure. (3) Methods: The authors performed a retrospective chart review of 65 (35 female and 30 male) patients who underwent transforaminal endoscopic decompression for failed non-operative treatment of lumbar disc herniation from 2012 to 2020. The patients’ age ranged from 22 to 86 years, with an average of 51.75 years. Patients in the experimental group (32 patients) had intraoperative neurophysiological monitoring recordings using sensory evoked (SSEP), and transcranial motor evoked potentials (TCEP), those in the control group (32 patients) did not. The SSEP and TCMEP data were analyzed and correlated to the postoperative course, including dysesthesia and clinical outcomes using modified Macnab criteria, Oswestry disability index (ODI), visual analog scale (VAS) for leg and back pain. (4) Results: The surgical levels were L4/L5 in 44.6%, L5/S1 in 23.1%, and L3/L4 in 9.2%. Of the 65 patients, 56.9% (37/65) had surgery on the left, 36.9% (24/65) on the right, and the remaining 6.2% (4/65) underwent bilateral decompression. Postoperative dysesthesia occurred in 2 patients in the experimental and six patients in the control group. In the experimental neuromonitoring group, there was electrodiagnostic evidence of compression of the exiting nerve root’s DRG in 24 (72.7%) of the 32 patients after initial transforaminal placement of the working cannula. A 5% or more decrease and a 50% or more decrease in amplitude of SSEPs and TCEPs recordings of the exiting nerve root were resolved by repositioning the working cannula or by pausing the root manipulation until recovery to baseline, which typically occurred within an average of 1.15 min. In 15 of the 24 patients with such latency and amplitude changes, a foraminoplasty was performed before advancing the endoscopic working cannula via the transforaminal approach into the neuroforamen to avoid an impeding nerve root injury and postoperative dysesthesia. (5) Conclusion: Neuromonitoring enabled the intraoperative diagnosis of DRG compression during the initial transforaminal placement of the endoscopic working cannula. Future studies with more statistical power will have to investigate whether employing neuromonitoring to avoid intraoperative compression of the exiting nerve root is predictive of lower postoperative dysesthesia rates in patients undergoing videoendoscopic transforaminal discectomy.

P95. Incidence and Etiology of Transient Nerve Root Injury with Lumbar Transforaminal Surgery

2007 ◽  
Vol 7 (5) ◽  
pp. 126S-127S
Author(s):  
Walter Eckman ◽  
Michelle McMillen ◽  
Lynda Hester
Keyword(s):  
Nerve Root ◽  
Nerve Root Injury ◽  
Root Injury
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