Anatomy and Ultrasound-Guided Injection of the Medial Branch of the Dorsal Ramus of the Cervical Spinal Nerves in the Horse: A Cadaveric Study

Abstract Objective The aim of this study was to describe the anatomy of the nerves supplying the cervical articular process joint and to identify relevant anatomical landmarks that could aid in the ultrasound-guided location and injection of these nerves for diagnostic and therapeutic purposes. Study Design Twelve cadaveric equine necks were used. Five necks were dissected to study the anatomy of the medial branch of the dorsal ramus of the cervical spinal nerves 3 to 7. Relevant anatomical findings detected during dissections were combined with ultrasonographic images obtained in one other neck. Six additional necks were used to assess the accuracy of ultrasound-guided injections of the medial branch with blue dye. Results Each examined cervical articular process joint, except for C2 to C3, presented a dual nerve supply. The articular process joints were found to be in close anatomical relationship with the medial branch of the dorsal ramus of the cervical spinal nerve exiting from the intervertebral foramen at the same level, and with the medial branch of the dorsal ramus of the cervical spinal nerve exiting from the intervertebral foramen one level cranial to the articular process joint of interest. A total of 55 nerves were injected under ultrasonographic guidance, 51 of which were successfully stained. Conclusion The current study provided new detailed information regarding the innervation of the cervical articular process joint. The medial branches of the dorsal rami of the cervical spinal nerves were injected with an accuracy that would be of clinical value. Our study offers the foundations to develop new diagnostic and therapeutic techniques for pain management in cervical articular process joint arthropathy in horses.

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Ultrasound-Guided Injection to the Fifth Cervical Spinal Nerve Root Level

American Journal of Physical Medicine & Rehabilitation ◽

10.1097/phm.0000000000000768 ◽

2017 ◽

Vol 96 (11) ◽

pp. e199-e200 ◽

Cited By ~ 1

Author(s):

Carl P.C. Chen ◽

Henry L. Lew ◽

Pei-Chi Huang ◽

Chia-Wei Yu

Keyword(s):

Nerve Root ◽

Spinal Nerve ◽

Spinal Nerve Root ◽

Ultrasound Guided ◽

Cervical Spinal Nerve

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Meningeal-neural relations in the intervertebral foramen

Journal of Neurosurgery ◽

10.3171/jns.1974.40.6.0756 ◽

1974 ◽

Vol 40 (6) ◽

pp. 756-763 ◽

Cited By ~ 65

Author(s):

Sydney Sunderland

Keyword(s):

Vertebral Column ◽

Transverse Process ◽

Spinal Nerve ◽

Intervertebral Foramen ◽

Nerve Roots ◽

Content Type ◽

Spinal Nerves ◽

Strong Attachment ◽

Relationship Of ◽

The Relationship

✓ The relationship of the meninges internally to the nerve roots, posterior root ganglion, and spinal nerve, and externally to the wall of the intervertebral foramen, has been investigated. The neural structures and their coverings are not attached to the foramen. Only the fourth, fifth, and sixth cervical spinal nerves have a strong attachment to the vertebral column, and this is to the gutter of the vertebral transverse process. The observations have relevance to any local lesion that may fix, deform, or otherwise affect the nerve and nerve roots to the point of interfering with their function. They may also be important to traction injuries of nerve roots.

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Ex Vivo Assessment of an Ultrasound-Guided Injection Technique of the Lumbosacral Disc in the Horse

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0039-1691793 ◽

2019 ◽

Vol 32 (05) ◽

pp. 383-388

Author(s):

Mickaël Robert ◽

Hadrien Manet ◽

Guillaume Manneveau ◽

Olivier Geffroy

Keyword(s):

Clinical Practice ◽

Ultrasound Guidance ◽

Ex Vivo ◽

Spinal Nerve ◽

Injection Technique ◽

Main Difficulty ◽

Intervertebral Foramen ◽

Spinal Nerve Roots ◽

Ultrasound Guided ◽

Nerve Roots

Abstract Objectives The aim of this study was to describe an ultrasound-guided injection technique of the lumbosacral disc in horses through the cranial vertebral notch of the sacrum and to evaluate both accuracy and potential complications of the technique on equine cadavers. Materials and Methods Twenty-four injections of the lumbosacral area were performed on 12 equine cadavers shortly after euthanasia under ultrasound guidance with the horse in recumbency using two different dyes (one colour for each side). The lumbosacral area was dissected in each horse and the accuracy of the technique, as well as its potential complications, was evaluated detecting the dyes and the structures that have been coloured. Results The lumbosacral area was correctly reached in only 11/24 injections. However, this technique allowed a lumbosacral peridiscal injection in 7/12 horses. The main difficulty was reaching the ventral opening of the L6-S1 intervertebral foramen that is partially hidden by the iliac wing on ultrasound. Puncture of the vertebral canal has been observed in 11/24 cases. The L6 spinal nerve roots emerging through the intervertebral foramen could potentially be damaged when inserting the needle. Clinical Significance The described ultrasound-guided technique allows peridiscal injection in the lumbosacral space in less than 60% of cases with potential sciatic nerve damage. Further investigations are warranted before using this technique in clinical practice in horses suffering from lumbosacral lesions.

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Macro anatomical investigation of brachial plexus of the White New Zealand rabbit (Orycotolagus cuniculus)

International Journal of Natural Sciences ◽

10.3329/ijns.v1i3.8825 ◽

1970 ◽

Vol 1 (3) ◽

pp. 74-76 ◽

Cited By ~ 6

Author(s):

M Mohiuddin ◽

ML Rahman ◽

MA Alim ◽

MBH Kabir ◽

MA Kashem

Keyword(s):

New Zealand ◽

Brachial Plexus ◽

Spinal Nerve ◽

Natural Sciences ◽

Spinal Nerves ◽

Zealand Rabbit ◽

Thoracic Spinal ◽

Cervical Spinal Nerve

In present study, the brachial plexus of the White New Zealand rabbit (Orycotolagus cuniculus) was investigated. Five adult rabbits were used and organizations of the brachial plexus of them were investigated. It was found that the brachial plexus of the rabbit was formed by rami ventralis of fifth cervical spinal nerve (C5), sixth cervical spinal nerve (C6), seventh cervical spinal nerve (C7), eighth cervical spinal nerve (C8), first thoracic spinal nerve (T1) and second thoracic spinal nerve (T2). The rami ventralis of C5 spinal nerve and T2 spinal nerve were divided into two branches. The caudal branch of C5 spinal nerve and cranial branch of T2 spinal nerve contributed to the brachial plexus. The caudal branch of C5 spinal nerve and C6 spinal nerve constituted the cranial trunk and the caudal trunk was formed by a branch which came from cranial trunk, rami ventralis of C7, C8, T1 spinal nerves and the cranial branch of ventral ramus of T2 spinal nerve. Contribution of caudal branch of ventral ramus of C5 spinal nerve and cranial branch of ventral ramus of T2 spinal nerve to the formation of the brachial plexus of rabbit and division of the brachial plexus to the caudal and cranial trunks resemble to porcupine and differ the brachial plexus of this species from those of rat, mouse and mammals.Key words: Spinal nerves; Orycotolagus cuniculus; Brachial plexus; Rabbits.DOI: http://dx.doi.org/10.3329/ijns.v1i3.8825International Journal of Natural Sciences (2011), 1(3):74-76

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Ultrasound-Guided Injection to the Fifth Cervical Spinal Nerve Root Level

American Journal of Physical Medicine & Rehabilitation ◽

10.1097/phm.0000000000000691 ◽

2017 ◽

Vol 96 (6) ◽

pp. e115-e116 ◽

Cited By ~ 1

Author(s):

Carl P.C. Chen ◽

Pei-Chi Huang ◽

Henry L. Lew ◽

Chia-Wei Yu

Keyword(s):

Nerve Root ◽

Spinal Nerve ◽

Spinal Nerve Root ◽

Ultrasound Guided ◽

Cervical Spinal Nerve

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Radiofrequency Thermocoagulation of Posterior Medial Branch of Cervical Spinal Nerve

Nerve Blockade and Interventional Therapy ◽

10.1007/978-4-431-54660-3_75 ◽

2019 ◽

pp. 299-301

Author(s):

Makoto Fukusaki

Keyword(s):

Spinal Nerve ◽

Medial Branch ◽

Radiofrequency Thermocoagulation ◽

Cervical Spinal Nerve

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Extraforaminal Thoracic and Lumbar Spinal Nerve Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation

Pain Medicine ◽

10.1093/pm/pnaa166 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

pp. S38-S40

Author(s):

Akshat Gargya ◽

Harmandeep Singh ◽

Tiffany Lin ◽

Amitabh Gulati

Keyword(s):

Peripheral Nerve ◽

Nerve Stimulation ◽

Spinal Nerve ◽

Peripheral Nerve Stimulation ◽

Ultrasound Guided ◽

Spinal Nerves ◽

Lead Placement ◽

Needle Trajectory ◽

Lumbar Spinal ◽

Stimulation Of

Abstract Objective Peripheral nerve stimulation provides targeted stimulation and pain relief within a specific nerve distribution. This technical case report provides a method to perform selective nerve root stimulation of thoracic and lumbar spinal nerves using ultrasonography. Methods Ultrasound-guided peripheral nerve stimulation of thoracic and lumbar spinal nerves allows better visualization of soft tissue anatomy and planning of needle trajectory. Conclusions Ultrasound-guided peripheral nerve stimulation procedures may provide a safer method for neurostimulation lead placement when compared with fluoroscopic-guided techniques.

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Macroanatomical Structure of the Lumbosacral Plexus and its Branches in the Indigenous Duck

Bangladesh Veterinary Journal ◽

10.32856/bvj-2018.01 ◽

2018 ◽

Vol 52 (1-4) ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

MT Hussan ◽

MS Islam ◽

J Alam

Keyword(s):

Hind Limb ◽

Femoral Nerve ◽

Morphological Structure ◽

Spinal Nerve ◽

The Body ◽

Lumbar Plexus ◽

Lumbosacral Plexus ◽

Sacral Plexus ◽

Spinal Nerves ◽

Femoral Cutaneous Nerve

The present study was carried out to determine the morphological structure and the branches of the lumbosacral plexus in the indigenous duck (Anas platyrhynchos domesticus). Six mature indigenous ducks were used in this study. After administering an anesthetic to the birds, the body cavities were opened. The nerves of the lumbosacral plexus were dissected separately and photographed. The lumbosacral plexus consisted of lumbar and sacral plexus innervated to the hind limb. The lumbar plexus was formed by the union of three roots of spinal nerves that included last two and first sacral spinal nerve. Among three roots, second (middle) root was the highest in diameter and the last root was least in diameter. We noticed five branches of the lumbar plexus which included obturator, cutaneous femoral, saphenus, cranial coxal, and the femoral nerve. The six roots of spinal nerves, which contributed to form three trunks, formed the sacral plexus of duck. The three trunks united medial to the acetabular foramen and formed a compact, cylindrical bundle, the ischiatic nerve. The principal branches of the sacral plexus were the tibial and fibular nerves that together made up the ischiatic nerve. Other branches were the caudal coxal nerve, the caudal femoral cutaneous nerve and the muscular branches. This study was the first work on the lumbosacral plexus of duck and its results may serve as a basis for further investigation on this subject.

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Ultrasound-Guided Insertion of the Ventricular Catheter in Ventriculoperitoneal Shunt Surgery: Evaluation of Accuracy and Feasibility in a Prospective Cohort

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0040-1714388 ◽

2020 ◽

Vol 82 (01) ◽

pp. 009-017

Author(s):

Severina Leu ◽

Maria Kamenova ◽

Luigi Mariani ◽

Jehuda Soleman

Keyword(s):

Ventriculoperitoneal Shunt ◽

Perioperative Complications ◽

Univariate Analysis ◽

Ventricular Catheter ◽

Neurosurgical Procedures ◽

Anatomical Landmarks ◽

Ultrasound Guided ◽

The Us ◽

Evans Index ◽

Shunt Survival

Abstract Objective Ventriculoperitoneal shunt (VPS) placement is one of the most frequent neurosurgical procedures. The position of the proximal catheter is important for shunt survival. Shunt placement is done either without image guidance (“freehand”) according to anatomical landmarks or by use of various image-guided techniques. Studies evaluating ultrasound-guided (US-G) VPS placement are sparse. We evaluate the accuracy and feasibility of US-G VPS placement, and compare it to freehand VPS placement. Methods We prospectively collected data of consecutive patients undergoing US-G VPS placement. Thereafter, the US cohort was compared with a cohort of patients in whom VPS was inserted using the freehand technique (freehand cohort). Primary outcome was accuracy of catheter positioning, and secondary outcomes were postoperative improvement in Evans' index (EI), rates of shunt dysfunction and revision surgery, perioperative complications, as well as operation, and anesthesia times. Results We included 15 patients undergoing US-G VPS insertion. Rates of optimally placed shunts were higher in the US cohort (67 vs. 49%, p = 0.28), whereas there were no malpositioned VPS (0%) in the US cohort, compared with 10 (5.8%) in the freehand cohort (p = 0.422). None of the factors in the univariate analysis showed significant association with nonoptimal (NOC) VPS placement in the US cohort. The mean EI improvement was significantly better in the US cohort than in the freehand cohort (0.043 vs. 0.014, p = 0.035). Conclusion Based on our preliminary results, US-G VPS placement seems to be feasible, safe, and increases the rate of optimally placed catheters.

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