scholarly journals COMPARATIVE STUDY OF LUMBAR PLEXUS PATH ON THE LEFT AND RIGHT SIDES THROUGH THE PSOAS MUSCLE

2018 ◽  
Vol 17 (4) ◽  
pp. 262-265
Author(s):  
Emiliano Neves Vialle ◽  
Luiz Roberto Gomes Vialle ◽  
Letícia Cardoso Ern ◽  
Luis Miguel Duchén Rodríguez ◽  
Grover Coaquira Huayta ◽  
...  
Keyword(s):  
Psoas Muscle ◽  
Transverse Process ◽  
Lateral Approach ◽  
Anatomical Landmark ◽  
Wilcoxon Test ◽  
Lumbar Plexus ◽  
Level Of Evidence ◽  
Left And Right ◽  
The Mean ◽  
The Right

ABSTRACT Objective: Spine surgery with a minimally invasive lateral approach and validate possible anatomical differences between the right and left sides. Methods: Four measurements (cm) were taken on 38 cadavers: the distance between the lumbar plexus and the transverse process (L4-L5) and the distance between the lumbar plexus and the midline of the lumbar spine, both on the right and left sides. Results: The mean distance between the lumbar plexus and the transverse process of L4-L5 was 1.03 cm and the distance to the midline was 3.99 cm for the right side. The averages of the left side were 1.13 cm and 3.38 cm, respectively. There is statistical difference between the sides (p<0.05) using the non-parametric Wilcoxon test. Conclusions: The authors suggest that the transverse process might be used as an anatomical landmark to define the surgical approach through the psoas muscle. Level of Evidence IV; Cadaveric study.

scholarly journals Age, Gender, Level and Side Differences in the Anatomical Distinctions of Unilateral Percutaneous Kyphoplasty through the Transverse ProcessPedicle Approach

2019 ◽  
Vol 2 (22.2) ◽  
pp. E91-E96
Author(s):  
Hongwei Wang
Keyword(s):  
Compression Fracture ◽  
Operation Time ◽  
Transverse Process ◽  
Vertebral Compression Fractures ◽  
Percutaneous Kyphoplasty ◽  
Inclination Angles ◽  
Left And Right ◽  
The Mean ◽  
The Right ◽  
L1 And L2

Background: Unilateral and bilateral percutaneous kyphoplasty (PKP) have been widely adopted to treat osteoporotic vertebral compression fractures (OVCFs). Unilateral PKP has a shorter operation time and less radiation exposure time compared with bilateral PKP, but the anatomical distinctions of unilateral PKP are not identical in all cases. Objective: The aim of this study was to examine the significance of age, gender, level, and side in relation to the anatomical distinctions of unilateral PKP for lumbar OVCFs through the transverse process-pedicle approach (TPPA). Study Design: This was a retrospective study of 200 patients. Setting: The research took place at General Hospital of Shenyang Military Area Command of Chinese PLA. Methods: Researchers examined 1000 lumbar spines (L1-L5) of 200 patients and simulated PKP on the 3D-CT scans through unilateral TPPA. The distance between the entry point and the midline of the vertebral body (DEM), the puncture inclination angle (PIA), the safe range of the inner inclination angles (SRA), and the success rate (SR) of puncture were measured and compared. Results: There were significant differences (P < 0.05) in the mean DEM between men and women, and between the left and right sides. The DEM was significantly larger in men than women and in right than left. The DEM from L1 to L5 was significantly increased (P < 0.05), from 22.4 ± 2.0 mm to 34.1 ± 4.3 mm. The right maximum PIA was significantly larger than the left. The maximum puncture angle and SRA in men was larger than that in women except for L5. The SRA from L1 to L5 was significantly increased (P < 0.05), from 20.1 ± 6.0 mm to 44.2 ± 8.8 mm. The SR from L1 to L5 was significantly increased (P < 0.05), from 88.3% to 100%. The SR in men was significantly higher than that in women for L1 and L2. Limitations: Sample size was relatively small. Conclusions: The DEM was 22.4 mm to 34.1 mm according to different levels. There were significant gender, side, and age differences in the DEM and PIA. The values of DEM, PIA, SRA and SR were significantly increased from L1 to L5. Key words: Lumbar, osteoporotic vertebral compression fracture, unilateral, percutaneous kyphoplasty, transverse process.

Minimally Invasive Lateral Retroperitoneal Approach for Resection of Extraforaminal Lumbar Plexus Schwannomas: Operative Techniques and Literature Review

2018 ◽  
Vol 15 (5) ◽  
pp. 516-521 ◽  
Author(s):  
Michael M Safaee ◽  
Christopher P Ames ◽  
Vedat Deviren ◽  
Aaron J Clark
Keyword(s):  
Minimally Invasive ◽  
Good Condition ◽  
Tumor Resection ◽  
Psoas Muscle ◽  
Lateral Approach ◽  
Lumbar Plexus ◽  
Retroperitoneal Approach ◽  
Transpsoas Approach ◽  
Lateral Interbody ◽  
Traditional Approaches

Abstract BACKGROUND Traditional approaches for retroperitoneal lumbar plexus schwannomas involve anterior open or laparoscopic resection. For select tumors, the lateral retroperitoneal approach provides a minimally invasive alternative. OBJECTIVE To describe a minimally invasive lateral transpsoas approach for the resection of retroperitoneal schwannomas. METHODS A lateral retroperitoneal transpsoas approach was used to resect a 3.1 × 2.7 × 4.1 cm schwannoma embedded within the psoas muscle. A minimally invasive retractor system allows for appropriate visualization and complete resection with the aid of the microscope. The patient tolerated the procedure without complication and was discharged on postoperative day 2 in good condition at her neurological baseline. RESULTS The lateral retroperitoneal approach provides a minimally invasive alternative for select retroperitoneal schwannomas. In theory, this procedure allows for faster recovery and less blood loss compared to traditional open anterior approaches. For a subset of tumors, anterior laparoscopy may provide better access, but the lateral approach is well known to most neurosurgeons who perform lateral interbody fusions and can be easily tailored to extraforaminal tumor resection. CONCLUSION Retroperitoneal schwannomas pose a challenge due to their deep location. The lateral retroperitoneal approach provides a useful alternative for resection of a subset of retroperitoneal schwannomas.

Inguinal Paravascular (Lumbar Plexus) Neurolytic Block—Description of a Catheter Technique: Case Report

1998 ◽  
Vol 23 (2) ◽  
pp. 214-218
Author(s):  
Abdullah M. Kaki ◽  
Geraint W. Lewis
Keyword(s):  
Case Report ◽  
Guide Wire ◽  
Femoral Nerve ◽  
Psoas Muscle ◽  
Pathologic Fracture ◽  
Sensory Block ◽  
Lumbar Plexus ◽  
Catheter Technique ◽  
Neurolytic Block ◽  
The Right

Background and ObjectivesWe provided care for a 47-year-old female with a history of lung carcinoma and bony metastases who sustained a pathologic fracture of the right acetabulum causing severe and uncontrolled pain in the right groin. Her pain was rated as 8-10 on a 10-point visual analog scale (VAS). Her terminal disease and poor surgical risk precluded therapeutic operative intervention. Consequently, a neurolytic block of the lumbar plexus was performed as a palliative measure.MethodsA modified inguinal paravascular (lumbar plexus) block technique was used. A 17-gauge Tuohy needle was inserted in the groin area just lateral to femoral artery and 1 cm below the inguinal ligament. A guide wire was threaded through the needle and subsequently an angiogram catheter was introduced over the wire into the psoas muscle. Radiographic confirmation of the position was obtained, and the catheter was secured in place. A prognostic block using an infusion of 0.25% bupivacaine at 5 mL/h was initiated for the first 2 days. On the third day a neurolytic block with 6% phenol was performed.ResultsMarked pain relief was experienced by the patient (VAS: 0-1). Sensory block in the femoral, lateral femoral cutaneous, and obturator nerve distributions was elicited. Motor weakness in the femoral nerve was demonstrated. Narcotic use was markedly reduced, and the patient was discharged to home in a pain-free state.ConclusionsThis case report supports the feasibility of placing a catheter via a modified anterior inguinal paravascular block technique and its subsequent use for both local anesthetic infusion and neurolytic block of the lumbar plexus.

Postnatal Development of a Left-Right Atrial Pressure Gradient

1956 ◽  
Vol 186 (3) ◽  
pp. 521-524 ◽  
Author(s):  
A. van Harreveld ◽  
F. E. Russell
Keyword(s):  
Left Ventricle ◽  
Pressure Gradient ◽  
Left Atrium ◽  
Postnatal Development ◽  
Right Atrial ◽  
Left And Right ◽  
The Mean ◽  
The Right ◽  
The Relationship ◽  
Equal Thickness

The mean left and right atrial pressures were measured in six groups of 10 kittens each. One group was examined between the 12th and 24th hour after birth, one group after 3 days, after 1 week, 2 weeks, 1 month and 2 months. The left and right atrial pressures were almost equal in the first group. With age an increasing left to right pressure gradient developed. In the oldest group the pressure in the left atrium was almost twice as great as in the right. Parallel with the pressure gradient a difference developed in the wall thicknesses of the left and right ventricles. At birth the ventricular walls were of about equal thickness; at age 2 months the left ventricle wall was more than twice as thick as the right. The relationship between ventricle wall thicknesses and atrial pressures is discussed.

Lumbar Plexus Anatomy within the Psoas Muscle: Implications for the Transpsoas Lateral Approach to the L4-L5 Disc

2011 ◽  
Vol 93 (16) ◽  
pp. 1482-1487 ◽  
Author(s):  
Timothy T Davis ◽  
Hyun W Bae ◽  
MAJ James M Mok ◽  
Alexandre Rasouli ◽  
Rick B Delamarter
Keyword(s):  
Psoas Muscle ◽  
Lateral Approach ◽  
Lumbar Plexus ◽  
Transpsoas Lateral Approach

scholarly journals Growth-Related Differences in Maximum Laterotrusion and Retrusion between Children and Adults

2009 ◽  
Vol 79 (2) ◽  
pp. 265-270 ◽  
Author(s):  
Claudia A. Reicheneder ◽  
Peter Proff ◽  
Uwe Baumert ◽  
Tomas Gedrange
Keyword(s):  
Temporomandibular Joint ◽  
Null Hypothesis ◽  
Population Based ◽  
Adult Group ◽  
Population Based Study ◽  
Significant Difference ◽  
Left And Right ◽  
The Mean ◽  
The Right

Abstract Objective: To test the null hypothesis that there are no differences between children and adults in maximum laterotrusion and maximum retrusion on the right and left sides. Materials and Methods: This population-based study included 81 randomly selected children between the ages of 6 and 10 years and 67 adults. Kinematic variables were measured with the ultrasonic JMA-System for registration. Results: The mean maximum laterotrusion of the children's group (10.6 ± 1.5 mm on the left, 11.0 ± 1.7 mm on the right) was significantly smaller than that of the adult group (11.7 ± 2.0 mm on the left, 12.2 ± 1.7 mm on the right). The maximum laterotrusion of the children's group corresponded to about 90% on the left and right sides of that of the adult group. The mean maximum retrusion of the children's group was significantly bigger than that of the adult group. There, the adult values corresponded to 66.7% on the left and 50% on the right side of the children's values. No significant difference in maximum laterotrusion and retrusion was noted on the right and left sides, and no significant differences according to gender specificities were observed in either group. Conclusions: The hypothesis is rejected. In development of the temporomandibular joint, maximum laterotrusion on the right and left sides increases significantly with age, and maximum retrusion decreases significantly with age.

scholarly journals Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study

2021 ◽  
Vol 87 (1) ◽  
pp. 175-179
Author(s):  
Thibault Dewilde ◽  
Sebastiaan Schelfaut ◽  
Sven Bamps ◽  
Matthias Papen ◽  
Pierre Moens
Keyword(s):  
Retrospective Study ◽  
Case Series ◽  
Technical Note ◽  
Coronal Alignment ◽  
Level Of Evidence ◽  
Coronal Balance ◽  
Scoliotic Deformity ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Obtaining a spine that is well balanced after fusion for scoliotic deformity is primordial for the patients’ quality of life. A simple T-shaped instrument combined with standard intraoperative fluoroscopy can be of great help to evaluate the coronal alignment quickly. The aim of this study was to evaluate if a T-shaped device could predict the postoperative coronal balance. Before finalization of the rod fixation, the balance was checked by verifying the relationship between the T-shaped instrument and the upper instrumented vertebra (UIV), and final adjustments were made to correct the coronal balance. A retrospective study was conducted on 48 patients who underwent surgery to correct scoliotic deformity. Intraoperative and postoperative coronal alignment was measured independently by two observers. The mean intraoperative horizontal offset measured between T-shaped instrument and the center of the UIV was 1,69mm to the right with a standard deviation (SD) of 12,43 mm. On postoperative full spine radiographs, the mean offset between the centra sacral vertical line and the center of the UIV was 2,44mm to the left with a SD of 13,10mm. There is no significant difference in coronal balance between both measurements (p=0,12). With this technique we were able to predict the postoperative coronal balance in all but one patient (97,92%). We conclude that the use of a simple T-shaped instrument can provide adequate intraoperative assessment of coronal balance in correcting scoliotic deformity. Level of evidence : IV – case series

scholarly journals Local Infiltration of Tranexamic Acid With Local Anesthetic Reduces Intraoperative Facelift Bleeding: A Preliminary Report

2019 ◽  
Author(s):  
Rafael A Couto ◽  
Ali Charafeddine ◽  
Nicholas R Sinclair ◽  
Laxmeesh M Nayak ◽  
James E Zins
Keyword(s):  
Tranexamic Acid ◽  
Local Anesthetic ◽  
Level Of Evidence ◽  
Time Saving ◽  
Local Infiltration ◽  
Lidocaine Solution ◽  
The Face ◽  
The Mean ◽  
Time Required ◽  
The Right

Abstract Background Rebound bleeding as a result of loss of epinephrine effect is a common problem encountered during facelift surgery. Tranexamic acid (TXA) is an anti-fibrinolytic agent whose safety and efficacy in reducing bleeding are well documented. We have found that local infiltration of TXA combined with a lidocaine with epinephrine solution during facelift surgery has been effective in decreasing rebound bleeding and the time required to gain hemostasis. Objectives The authors sought to share their local infiltration protocol of TXA combined with epinephrine solution in facelift. Methods Patients who underwent facelift received subcutaneous injection of TXA-lidocaine 0.5% solution following the authors’ protocol. After completing both sides of the facelift and the submental platysmaplasty, the first and second sides were sequentially closed. The time to gain hemostasis on each side prior to closure was prospectively measured. Results Twenty-seven consecutive patients who underwent facelift surgery received local infiltration of TXA-lidocaine solution. In 23 of the 27 patients, the time required for hemostasis was prospectively recorded. The mean age was 62.1 years (±9.3) and all were females. The average time spent achieving hemostasis on the right, left, and both sides of the face was 6.5 (±2.7), 6.3 (±2.1), and 12.9 (±4.2) minutes, respectively. The total surgical time saving is approximately 25 to 60 minutes. Although primary facelift [13.6 (± 4.3)] exhibited a longer time of hemostasis compared with the secondary group [10.2 (± 2.8)], this was not statistically significant (P = 0.09). Conclusions Local infiltration of TXA with local anesthetic prior to a facelift appears to decrease bleeding, operative time, and postoperative facelift drainage output. Level of Evidence: 4

Curvature measurement of human bilateral cochleae

2015 ◽  
Vol 129 (11) ◽  
pp. 1085-1090 ◽  
Author(s):  
J-F Yu ◽  
K-C Lee ◽  
Y-L Wan ◽  
Y-C Peng
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cochlear Implantation ◽  
Resonance Imaging ◽  
Basal Turn ◽  
Curvature Measurement ◽  
Left And Right ◽  
The Mean ◽  
Potential Damage ◽  
The Right

AbstractObjective:This study aimed to characterise the geometry of the human bilateral spiral cochlea by measuring curvature and length.Method:Eight subjects were recruited in this study. Magnetic resonance imaging was used to visualise the right and left cochlea. Visualisation of the cochlear spiral was enhanced by T2 weighting and further processing of the raw images. The spirals were divided into three segments: the basal turn, the middle turn and the apex turn. The length and curvature of each segment were non-invasively measured.Results:The mean left and right cochlear lengths were 3.11 cm and 3.95 cm, respectively. The measured lengths of the cochlear spiral are consistent with data in the literature derived from anatomical dissections. Overall, the apex turn segment of the cochlea had the greatest degree of curvature (p < 0.05). The mean apex turn segment curvatures for left and right cochleae were 9.65 cm−1 and 10.09 cm−1, respectively.Conclusion:A detailed description of the cochlear spiral is provided, using measurements of curvature and length. These data will provide a valuable reference in the development of cochlear implantation procedures for minimising the potential damage during implantation.

Sign in / Sign up

Export Citation Format

Share Document