Evaluation of the anatomic effect of physical therapy exercises for mobilization of lumbar spinal nerves and the dura mater in dogs

OBJECTIVEThe aim of this retrospective multicenter cohort study was to assess the details of the angioarchitecture of arteriovenous fistulas (AVFs) at the craniocervical junction (CCJ) and to determine the associations between the angiographic characteristics and the clinical presentations and outcomes.METHODSThe authors analyzed angiographic and clinical data for patients with CCJ AVFs from 20 participating centers that are members of the Japanese Society for Neuroendovascular Therapy (JSNET). Angiographic findings (feeding artery, location of AV shunt, draining vein) and patient data (age, sex, presentation, treatment modality, outcome) were tabulated and stratified based on the angiographic types of the lesions, as diagnosed by a member of the CCJ AVF study group, which consisted of a panel of 6 neurointerventionalists and 1 spine neurosurgeon.RESULTSThe study included 54 patients (median age 65 years, interquartile range 61–75 years) with a total of 59 lesions. Five angiographic types were found among the 59 lesions: Type 1, dural AVF (22 [37%] of 59); Type 2, radicular AVF (17 [29%] of 59); Type 3, epidural AVF (EDAVF) with pial feeders (8 [14%] of 59); Type 4, EDAVF (6 [10%] of 59); and Type 5, perimedullary AVF (6 [10%] of 59). In almost all lesions (98%), AV shunts were fed by radiculomeningeal arteries from the vertebral artery that drained into intradural or epidural veins through AV shunts on the dura mater, on the spinal nerves, in the epidural space, or on the spinal cord. In more than half of the lesions (63%), the AV shunts were also fed by a spinal pial artery from the anterior spinal artery (ASA) and/or the lateral spinal artery. The data also showed that the angiographic characteristics associated with hemorrhagic presentations—the most common presentation of the lesions (73%)—were the inclusion of the ASA as a feeder, the presence of aneurysmal dilatation on the feeder, and CCJ AVF Type 2 (radicular AVF). Treatment outcomes differed among the angiographic types of the lesions.CONCLUSIONSCraniocervical junction AVFs commonly present with hemorrhage and are frequently fed by both radiculomeningeal and spinal pial arteries. The AV shunt develops along the C-1 or C-2 nerve roots and can be located on the spinal cord, on the spinal nerves, and/or on the inner or outer surface of the dura mater.

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Poster 534 The Importance of Rehabilitation (Physical Therapy) after Lumbar Spinal Injection for Spinal Pain Patient. A Retrospective Chart Review of 1600 Spinal Patients

PM&R ◽

10.1016/j.pmrj.2014.08.900 ◽

2014 ◽

Vol 6 (9) ◽

pp. S373

Author(s):

Yung C. Chen

Keyword(s):

Physical Therapy ◽

Chart Review ◽

Retrospective Chart Review ◽

Spinal Pain ◽

Pain Patient ◽

Spinal Injection ◽

Lumbar Spinal

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Ultrasound‐Guided Peripheral Nerve Stimulation of Cervical, Thoracic, and Lumbar Spinal Nerves for Dermatomal Pain: A Case Series

Neuromodulation Technology at the Neural Interface ◽

10.1111/ner.13334 ◽

2020 ◽

Author(s):

Ojas Mainkar ◽

Harmandeep Singh ◽

Akshat Gargya ◽

Jane Lee ◽

Ali Valimahomed ◽

...

Keyword(s):

Peripheral Nerve ◽

Nerve Stimulation ◽

Case Series ◽

Peripheral Nerve Stimulation ◽

Ultrasound Guided ◽

Spinal Nerves ◽

Lumbar Spinal ◽

Stimulation Of

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Movements of supernumerary hindlimbs after innervation by single lumbar spinal nerves ofXenopus laevis

Cellular and Molecular Life Sciences ◽

10.1007/bf01922734 ◽

1979 ◽

Vol 35 (4) ◽

pp. 506-508 ◽

Cited By ~ 1

Author(s):

D. Kleinebeckel

Keyword(s):

Spinal Nerves ◽

Lumbar Spinal

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A comparative study of 2-year follow-up outcomes in lumbar spinal stenosis patients treated with physical therapy alone and those with surgical intervention after less successful physical therapy

Journal of Orthopaedic Science ◽

10.1016/j.jos.2018.01.003 ◽

2018 ◽

Vol 23 (3) ◽

pp. 470-476 ◽

Cited By ~ 3

Author(s):

Masakazu Minetama ◽

Mamoru Kawakami ◽

Masafumi Nakagawa ◽

Yuyu Ishimoto ◽

Keiji Nagata ◽

...

Keyword(s):

Physical Therapy ◽

Comparative Study ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Surgical Intervention ◽

Lumbar Spinal

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The Posterior Epidural Ligaments: A Cadaveric and Histological Investigation in the Lumbar Region

ISRN Anatomy ◽

10.5402/2013/424058 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

M. J. Connor ◽

S. Nawaz ◽

V. Prasad ◽

S. Mahir ◽

R. Rattan ◽

...

Keyword(s):

Dura Mater ◽

Spinal Surgery ◽

Ligamentum Flavum ◽

Dorsal Surface ◽

Lumbar Region ◽

Intraoperative Awareness ◽

Cross Sectional ◽

Poorly Differentiated ◽

Lumbar Spinal ◽

Incidental Durotomy

Purpose. Incidental durotomy is a relatively common complication for patients undergoing posterior spinal surgery. Delineating anatomical variants in the posterior lumbar spinal canal is crucial in reducing future rates of incidental durotomy. Materials and Methods. The ligamentous attachments between the dura mater and ligamentum flavum in the lumbar region of 17 soft-fixed cadavers were investigated. The lumbar vertebral columns were removed, and cross-sectional dissection was performed at levels L1-S1. Anterior retraction of the dorsal dura mater identified attachments between the dorsal surface of the dura mater and the ligamentum flavum. Histological staining of the ligamentous attachments was carried out with hematoxylin and eosin (H&E) and elastic van Gieson (EVG). Results. Posterior epidural ligaments were present in 9 (52.9%) cadavers. Nine (9) separate ligaments were identified in these cadavers, with 3 (33.3%) at L3/L4, 5 (55.5%) at L4/L5, and 1 (11.1%) at L5/S1. Histology confirmed the presence of poorly differentiated collagen-based connective tissue, distinct from the normal anatomy. Conclusions. This study confirms the presence of multiple dorsomedial posterior epidural ligaments at the main sites for posterior spinal surgery (L3-S1). An intraoperative awareness of the variability of such connections may be an important step in reducing static rates of incidental durotomy.

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Nonsurgical management of patients with lumbar spinal stenosis: a literature review and a case series of three patients managed with physical therapy

Physical Medicine and Rehabilitation Clinics of North America ◽

10.1016/s1047-9651(02)00076-1 ◽

2003 ◽

Vol 14 (1) ◽

pp. 77-101 ◽

Cited By ~ 44

Author(s):

Julie M Whitman ◽

Timothy W Flynn ◽

Julie M Fritz

Keyword(s):

Physical Therapy ◽

Literature Review ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Case Series ◽

Nonsurgical Management ◽

Lumbar Spinal

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Posterior Branches of Lumbar Spinal Nerves – part II: Lumbar Facet Syndrome – Pathomechanism, Symptomatology and Diagnostic Work-up

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/15093492.1237716 ◽

2017 ◽

Vol 19 (2) ◽

pp. 101-109 ◽

Cited By ~ 2

Author(s):

Katarzyna Kozera ◽

Bogdan Ciszek ◽

Paweł Szaro

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Facet Joint ◽

Medial Branch ◽

Low Back ◽

Spinal Nerves ◽

Lower Lumbar Spine ◽

Facet Syndrome ◽

Lumbar Spinal ◽

Lumbar Facet

Posterior branches of the lumbar spinal nerves are the anatomic substrate of pain in the lower back, sacrum and the gluteal area. Such pain may be associated with various pathologies which cause pain in the posterior branches of the lumbar spinal nerves due to entrapment, mechanical irritation or inflammatory reaction and/or degeneration. The posterior branches are of significant functional importance, which is related to the function of the structures they supply, including facet joints, which are the basic biomechanical units of the spine. Low back pain caused by facet joint pathology may be triggered e.g. by simple activities, such as body rotations, unnatural positions, lifting heavy weights or excessive bending as well as chronic overloading with spinal hyperextension. Pain usually presents at the level of the lumbosacral junction (L 5 -S 1 ) and in the lower lumbar spine (L 4-5 , L 3-4 ). In the absence of specific diagnostic criteria, it is only possible to conclude that patients display tenderness at the level of the affected facet joint and that the pain is triggered by extension. Differential diagnosis for low back pain is difficult, since the pain may originate from various structures. The most reliable method of identifying Lumbar Facet Syndrome has been found to be a positive response to an analgesic procedure in the form of a block of the medial branch or intraarticular injection. There appear to be good grounds for conducting further studies and developing unequivocal diagnostic tests.

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Acupuncture Points of the Lumbar Plexus

The American Journal of Chinese Medicine ◽

10.1142/s0192415x85000186 ◽

1985 ◽

Vol 13 (01n04) ◽

pp. 133-143 ◽

Cited By ~ 6

Author(s):

H.C. Dung

Keyword(s):

Body Wall ◽

Lumbar Plexus ◽

Acupuncture Points ◽

Lumbar Region ◽

Lower Abdomen ◽

Spinal Nerves ◽

Medial Surface ◽

Anatomic Basis ◽

Lumbar Spinal

This communication is the fifth in a series of six publications describing acupuncture points by anatomic nomenclature. This article describes acunpuncture points in the lumbar region of the posterior body wall, the inguinal and pelvic regins of the lower abdomen, and the medial surface of the thigh and leg. Acunpuncture points in these regions are generally established by anatomic features of the lumbar spinal nerves. Nerve branches of the posterior primary rami of the lumbar spinal nerves and the lumbar plexus provide the anatomic basis for acunpuncture points in these regions and are used to name the points accordingly.

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