Accidental Strangulation with Cervical Nerve Root Injury Caused by the Entrapment of Clothing in a Soybean Milling Machine

The clothing of a forty-five-year-old man became entrapped by the mixing rotator while he was operating a soybean milling machine. His clothing was wound around the rotator, and tightened around his neck and chest, causing strangulation and a loss of consciousness. He was rescued by his coworkers and transported to our hospital by helicopter. Upon arrival, he regained consciousness. A physiological examination revealed multiple petechiae on his face and strangulation marks with subcutaneous hemorrhage on his neck and upper trunk. In addition, he had motor weakness of the right upper extremity and bilateral paresthesia from C5 to Th1. All radiological studies were negative. He was admitted for observation. After the patient’s creatine phosphokinase level peaked and his focal neurological signs improved, he was discharged on foot on the 6th hospital day. Accidental ligature strangulation with cervical nerve root injury, in which an article of clothing is caught in an electrical machine and strangles the wearer, is very rare. This case is presented for its rarity and the unique pattern of injury.

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

Biomaterials ◽

10.1016/j.biomaterials.2011.09.021 ◽

2011 ◽

Vol 32 (36) ◽

pp. 9738-9746 ◽

Cited By ~ 9

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

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Management Approach of Penetrating Vertebral Artery Injury with Concomitant Cervical Nerve Root Injury in Regional Hospital: Report of Two Cases

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.09.002 ◽

2018 ◽

Vol 25 (1) ◽

pp. 5-10

Author(s):

Lam Yuk-Yu ◽

Tsui Hon-For ◽

Wong Hok-Leung ◽

Chow Yuk-Yin

Keyword(s):

Vertebral Artery ◽

Nerve Root ◽

Endovascular Intervention ◽

Vertebral Artery Injury ◽

Management Approach ◽

Cervical Nerve Root ◽

Cervical Nerve ◽

Nerve Root Injury ◽

Artery Injury ◽

Root Injury

Penetrating vertebral artery injury is uncommon yet potentially fatal. We present two cases of penetrating vertebral artery injury with concomitant cervical nerve root injury managed in our centre. The first case was a young gentleman who suffered from neck injury by broken metal fragment. Cervical nerve root injury was suspected preoperatively. Massive bleeding from vertebral artery was encountered during wound exploration. It was managed by ligation, followed by retrograde endovascular embolisation. The second case was a young lady being assaulted with knife and fork over the neck. She was also suspected to have cervical nerve root injury preoperatively. Vascular control of vertebral artery was achieved with endovascular intervention. Subsequent operation for foreign body removal and nerve root repair was performed with minimal bleeding intraoperatively. Management approach of penetrating vertebral artery injury with concomitant cervical nerve root injury and the role of endovascular intervention were discussed.

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Isolated cervical nerve root injury treated successfully by operative decompression

Injury ◽

10.1016/0020-1383(93)90061-a ◽

1993 ◽

Vol 24 (5) ◽

pp. 341-342 ◽

Cited By ~ 1

Author(s):

N.D. Kitchen ◽

N.D. Mendoza ◽

R. Bradford

Keyword(s):

Nerve Root ◽

Cervical Nerve Root ◽

Cervical Nerve ◽

Nerve Root Injury ◽

Root Injury ◽

Operative Decompression

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The Roles of Mechanical Compression and Chemical Irritation in Regulating Spinal Neuronal Signaling in Painful Cervical Nerve Root Injury

10.4271/2013-22-0009 ◽

2013 ◽

Author(s):

Sijia Zhang ◽

Kristen J. Nicholson ◽

Jenell R. Smith ◽

Taylor M. Gilliland ◽

Peter P. Syré ◽

...

Keyword(s):

Nerve Root ◽

Mechanical Compression ◽

Cervical Nerve Root ◽

Cervical Nerve ◽

Neuronal Signaling ◽

Nerve Root Injury ◽

Root Injury ◽

Chemical Irritation

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Spinal Neuropeptide Responses in Persistent and Transient Pain Following Cervical Nerve Root Injury

Spine ◽

10.1097/01.brs.0000186316.38111.4b ◽

2005 ◽

Vol 30 (22) ◽

pp. 2491-2496 ◽

Cited By ~ 42

Author(s):

Sarah M. Rothman ◽

Rob A. Kreider ◽

Beth A. Winkelstein

Keyword(s):

Nerve Root ◽

Cervical Nerve Root ◽

Cervical Nerve ◽

Nerve Root Injury ◽

Root Injury

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Anatomy of the L5 nerve root in the pelvis for safe sacral screw placement: a cadaveric study

Journal of Neurosurgery Spine ◽

10.3171/2021.8.spine21962 ◽

2021 ◽

pp. 1-6

Author(s):

Shota Tamagawa ◽

Takatoshi Okuda ◽

Hidetoshi Nojiri ◽

Tatsuya Sato ◽

Rei Momomura ◽

...

Keyword(s):

Nerve Root ◽

Sagittal Plane ◽

Pedicle Screws ◽

Cadaveric Study ◽

Nerve Roots ◽

Nerve Root Injury ◽

Inflection Points ◽

Root Injury ◽

The Right ◽

Intervertebral Foramina

OBJECTIVE Previous reports have focused on the complications of L5 nerve root injury caused by anterolateral misplacement of the S1 pedicle screws. Anatomical knowledge of the L5 nerve root in the pelvis is essential for safe and effective placement of the sacral screw. This cadaveric study aimed to investigate the course of the L5 nerve root in the pelvis and to clarify a safe zone for inserting the sacral screw. METHODS Fifty-four L5 nerve roots located bilaterally in 27 formalin-fixed cadavers were studied. The ventral rami of the L5 nerve roots were dissected along their courses from the intervertebral foramina to the lesser pelvis. The running angles of the L5 nerve roots from the centerline were measured in the coronal plane. In addition, the distances from the ala of the sacrum to the L5 nerve roots were measured in the sagittal plane. RESULTS The authors found that the running angles of the L5 nerve roots changed at the most anterior surface of the ala of the sacrum. The angles of the bilateral L5 nerve roots from the right and left L5 intervertebral foramina to their inflection points were 13.77° ± 5.01° and 14.65° ± 4.71°, respectively. The angles of the bilateral L5 nerve roots from the right and left inflection points to the lesser pelvis were 19.66° ± 6.40° and 20.58° ± 5.78°, respectively. There were no significant differences between the angles measured in the right and left nerve roots. The majority of the L5 nerves coursed outward after changing their angles at the inflection point. The distances from the ala of the sacrum to the L5 nerve roots in the sagittal plane were less than 1 mm in all cases, which indicated that the L5 nerve roots were positioned close to the ala of the sacrum and had poor mobility. CONCLUSIONS All of the L5 nerve roots coursed outward after exiting the intervertebral foramina and never inward. To prevent iatrogenic L5 nerve root injury, surgeons should insert the S1 pedicle screw medially with an angle > 0° toward the inside of the S1 anterior foramina and the sacral alar screw laterally with an angle > 30°.

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Cervical Dumbbell Intra-extradural Hemangioblastoma: Total Removal through the Lateral Approach: Technical Case Report

Neurosurgery ◽

10.1227/01.neu.0000154134.83900.05 ◽

2005 ◽

Vol 56 (3) ◽

pp. E625-E625 ◽

Cited By ~ 13

Author(s):

Cédric Barrey ◽

Michel Kalamarides ◽

Marc Polivka ◽

Bernard George

Keyword(s):

Vertebral Artery ◽

Nerve Root ◽

Histopathological Examination ◽

Lateral Approach ◽

Primary Control ◽

Cervical Nerve Root ◽

Cervical Nerve ◽

Dumbbell Tumor ◽

Computed Tomographic ◽

The Right

Abstract OBJECTIVE AND IMPORTANCE: Extradural hemangioblastomas account for 8 to 12% of all spinal hemangioblastomas. Among them, intra-extradural forms with a dumbbell extension are extremely rare. We report a case of intra-extradural hemangioblastoma involving the C6 cervical nerve root. CLINICAL PRESENTATION: The patient was a 31-year-old woman presenting with signs of myelopathy and C6 radiculopathy on the right side. A computed tomographic scan and magnetic resonance imaging demonstrated a dumbbell tumor that had developed through the C5–C6 intervertebral foramen. Angiography revealed a well-circumscribed mass with feeders from the vertebral artery and the deep cervical artery. INTERVENTION: The tumor was totally removed through the lateral approach, with control of the vertebral artery and sacrifice of the C6 cervical nerve root. Limited bone drilling to enlarge the foramen permitted us to reach and resect the intradural component. Histopathological examination confirmed the diagnosis of hemangioblastoma. Follow-up was uneventful. CONCLUSION: This is the sixth reported case of a cervical dumbbell hemangioblastoma investigated by computed tomographic scanning and MRI but the first one resected via the lateral approach. The lateral approach seems appropriate for surgical resection because it provides primary control of the vascular feeders and access to the extradural and intradural components.

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Nerve injury following ultrasound-guided nerve root block with 2% lidocaine for shoulder manipulation: a case report

Journal of International Medical Research ◽

10.1177/03000605211047770 ◽

2021 ◽

Vol 49 (9) ◽

pp. 030006052110477

Author(s):

Soyoung Kwak ◽

Min Cheol Chang

Keyword(s):

Nerve Root ◽

Rating Scale ◽

Adhesive Capsulitis ◽

Numeric Rating Scale ◽

University Hospital ◽

Nerve Root Block ◽

Nerve Root Injury ◽

Root Injury ◽

Shoulder Abductor ◽

The Right

Shoulder manipulation under ultrasound (US)-guided C5 and C6 nerve root block is effective for treating refractory adhesive capsulitis (AC). We herein report the development of cervical nerve root injury following manipulation under anesthesia (MUA) in a patient with AC. A 47-year-old woman underwent shoulder manipulation under US-guided C5 and C6 root block with 2% lidocaine for the management of AC-induced shoulder pain. For the procedure, 3 mL of 2% lidocaine (total of 6 mL) was injected around each C5 and C6 nerve root under US guidance. Seven days after the procedure, the patient visited a university hospital because of severe neuropathic pain (numeric rating scale score of 9) in the right anterior arm, lateral arm, and forearm areas. Sensory deficits in the corresponding C5 and C6 dermatomes and motor weakness of the right shoulder abductor, elbow flexor, and wrist extensor were observed. Electrophysiologic studies demonstrated C5 and C6 nerve root injury. The patient was diagnosed with right C5 and C6 nerve root injury following MUA, and lidocaine toxicity or ischemia was the suspected cause. Clinicians should be mindful of the possibility of this complication.

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Rating Spinal Nerve Extremity Impairment Using the Sixth Edition

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2009.julaug01 ◽

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.

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