THE HARMFUL COMPLICATIONS OF PERIPHERAL NERVES IN NEUROSURGICAL PRACTICE

Vestnik ◽  
2021 ◽  
pp. 131-135
Author(s):  
Е.К. Дюсембеков ◽  
А.Р. Халимов ◽  
И.Т. Курмаев ◽  
А.В. Николаева ◽  
А.С. Жайлаубаева ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Preventive Measures ◽  
Nerve Injuries ◽  
Absolute Value ◽  
Iatrogenic Injuries ◽  
Common Causes ◽  
Working Age ◽  
Late Referral

Проведено исследование 93 пациентов с ятрогенными повреждениями периферических нервов, 11,7% по отношению ко всем оперированным пациентам. Женщин было 51, мужчин 42. Пациенты трудоспособного возраста составили 88%. Позднее обращение за специализированной нейрохирургической помощью составило 53,7%. Чаще всех повреждался седалищный нерв - 29,1%, затем лучевой нерв - 22,6%. Наиболее частые причины ятрогенных осложнений - это операции на опорно-двигательном аппарате (79 - 84,9%). Представлены виды оперативных вмешательств, предложены меры по профилактике и своевременному специализированному лечению больных с ятрогенными повреждениями нервов. Research has been done of 93 patients with iatrogenic injuries of peripheral nerves. It amounted to 11,7 per cent of all patients, who received surgical treatment. In the absolute value, there were 51 men and 42 women in gender equivalent. The significant quantity of working age patients amounts to 88%. 53.7% - it is late referral to specialized neurosurgical care. The volume of sciatic nerve injuries was the largest and amounted to 29,1%, the next a radial nerve - 22,6%. Most common causes of harmful complications there are operations on the musculoskeletal system (79 - 84,9%).The article shows the types of surgery, preventive measures and timely specialized treatment of patients with iatrogenic nerve injuries were proposed

scholarly journals Series of Cases with Iatrogenic Nerve Injury

1970 ◽  
Vol 28 (2) ◽  
pp. 121-124
Author(s):  
Selina Daisy ◽  
Quazi Deen Mohammad ◽  
Azharul Hoque ◽  
Badrul Alam ◽  
Badrul Haque ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Femoral Nerve ◽  
Accessory Nerve ◽  
Nerve Injuries ◽  
Sacral Plexus ◽  
Iatrogenic Injuries ◽  
Iatrogenic Nerve Injury ◽  
Femoral Nerve Injury

After introduction of EMG at Dhaka Medical Collage onJanuary 01, 2006, a total of 415 cases referred to EMGlaboratory for electrophysiological evaluation over a periodof two years(January 01, 2006 to December 31, 2007). Among these, 7cases diagnosed as iatrogenic nerve injuries. The subtypesof iatrogenic nerve injuries were:1. Accessory nerve injury: three, 2. Femoral nerve injury:one, 3. Sciatic nerve injury: one,4. Lumbar sacral plexus injury: one, 5. Combined sciaticand femoral nerve injury: oneIn order to investigate the causes, diagnosis & preventionof iatrogenic nerve injuries; we have reviewed 7 cases ofiatrogenic nerve injuries. The peripheral nerve injuriesoccurred due to lack of proper awareness of medicalpersonals. These injuries are iatrogenic injuries so it isuseful to review the mode of injuries and means ofprevention.DOI: 10.3329/jbcps.v28i2.5373J Bangladesh Coll Phys Surg 2010; 28: 121-124

Management and results of sciatic nerve injuries: a 24-year experience

1998 ◽  
Vol 89 (1) ◽  
pp. 13-23 ◽  
Author(s):  
David G. Kline ◽  
Daniel Kim ◽  
Rajiv Midha ◽  
Carter Harsh ◽  
Robert Tiel
Keyword(s):  
Sciatic Nerve ◽  
Spontaneous Recovery ◽  
Nerve Injuries ◽  
Management Guidelines ◽  
Content Type ◽  
Surgical Exploration ◽  
Excellent Outcome ◽  
Retrospective Clinical Study ◽  
Late Referral ◽  
Fine Print

Object. The purpose of this retrospective clinical study was to present results and provide management guidelines for various types of sciatic injuries. Methods. Over a 24-year period, 380 patients with sciatic nerve injuries were managed. In 230 patients (60%), the injury was at the buttock level, with injection injuries comprising more than half of these cases. Thigh-level sciatic injury was evaluated in 150 cases (40%) and was usually secondary to one of four main causes: 1) gunshot wound; 2) femur fracture; 3) laceration; or 4) contusion. Patients with partial deficits uncomplicated by severe pain or with significant spontaneous recovery or late referral were managed medically. Surgical exploration was not indicated in 23% of injuries at the thigh level and almost 50% of those at the buttock level. Most of these patients achieved partial but good spontaneous recovery, especially in the tibial division distribution. Surgical intervention was required for more complete and persistent deficits in either the tibial or peroneal distribution. Divisions of the sciatic nerve were split apart and evaluated independently. Management was guided by nerve action potential (NAP) recordings, which indicated whether neurolysis or resection of the lesion was required. Repair was then made by using sutures or more frequently by graft placement. In most cases in which neurolysis was performed because a positive NAP was recorded distal to the lesion, useful function was found in the peroneal distribution. Unfortunately, significant recovery occurred in only 36% of patients who received suture or graft repairs of the peroneal division. Good-to-excellent outcome was common for the tibial division, even in cases in which repair was proximal and required lengthy grafts. The relatively favorable recovery of tibial as opposed to peroneal divisions of the sciatic nerve occurred regardless of the level or mechanism of injury. Conclusions. Surgical exploration and, when necessary, repair of sciatic nerve injuries is worthwhile in selected cases.

Surgical treatment of gunshot injuries of peripheral nerves

1923 ◽  
Vol 19 (5) ◽  
pp. 18-24
Author(s):  
V. L. Bogolyubov
Keyword(s):  
Surgical Treatment ◽  
Peripheral Nerves ◽  
World War ◽  
Nerve Injuries ◽  
Gunshot Injuries

The issue of surgical treatment of gunshot injuries of peripheral nerves until the last war seemed to be extremely underdeveloped. Only the experience of the last World War clarified many aspects of this issue, significantly changing the surgeons' views on the treatment of nerve wounds. However, despite this, even at present the issue of surgical treatment of gunshot nerve injuries seems to be far from exhausted and deserves attention in many respects.

scholarly journals MR Imaging of Peripheral Nerves Using Targeted Application of Contrast Agents: An Experimental Proof-of-Concept Study

2020 ◽  
Vol 7 ◽  
Author(s):  
Vlad Tereshenko ◽  
Irena Pashkunova-Martic ◽  
Krisztina Manzano-Szalai ◽  
Joachim Friske ◽  
Konstantin D. Bergmeister ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Contrast Agent ◽  
Contrast Agents ◽  
Peripheral Nerves ◽  
Proof Of Concept ◽  
Peripheral Nerve Injuries ◽  
Radiological Imaging ◽  
Nerve Injuries ◽  
Experimental Proof

Introduction: Current imaging modalities for peripheral nerves display the nerve's structure but not its function. Based on a nerve's capacity for axonal transport, it may be visualized by targeted application of a contrast agent and assessing the distribution through radiological imaging, thus revealing a nerve's continuity. This concept has not been explored, however, may potentially guide the treatment of peripheral nerve injuries. In this experimental proof-of-concept study, we tested imaging through MRI after administering gadolinium-based contrast agents which were then retrogradely transported.Methods: We synthesized MRI contrast agents consisting of paramagnetic agents and various axonal transport facilitators (HSA-DTPA-Gd, chitosan-DTPA-Gd or PLA/HSA-DTPA-Gd). First, we measured their relaxivity values in vitro to assess their radiological suitability. Subsequently, the sciatic nerve of 24 rats was cut and labeled with one of the contrast agents to achieve retrograde distribution along the nerve. One week after surgery, the spinal cords and sciatic nerves were harvested to visualize the distribution of the respective contrast agent using 7T MRI. In vivo MRI measurements were performed using 9.4 T MRI on the 1st, 3rd, and the 7th day after surgery. Following radiological imaging, the concentration of gadolinium in the harvested samples was analyzed using inductively coupled mass spectrometry (ICP-MS).Results: All contrast agents demonstrated high relaxivity values, varying between 12.1 and 116.0 mM−1s−1. HSA-DTPA-Gd and PLA/HSA-DTPA-Gd application resulted in signal enhancement in the vertebral canal and in the sciatic nerve in ex vivo MRI. In vivo measurements revealed significant signal enhancement in the sciatic nerve on the 3rd and 7th day after HSA-DTPA-Gd and chitosan-DTPA-Gd (p < 0.05) application. Chemical evaluation showed high gadolinium concentration in the sciatic nerve for HSA-DTPA-Gd (5.218 ± 0.860 ng/mg) and chitosan-DTPA-Gd (4.291 ± 1.290 ng/mg).Discussion: In this study a novel imaging approach for the evaluation of a peripheral nerve's integrity was implemented. The findings provide radiological and chemical evidence of successful contrast agent uptake along the sciatic nerve and its distribution within the spinal canal in rats. This novel concept may assist in the diagnostic process of peripheral nerve injuries in the future.

scholarly journals SURGICAL TREATMENT OF PERIPHERAL NERVES COMBAT WOUNDS OF THE EXTREMITIES

2021 ◽  
Vol 74 (3) ◽  
pp. 619-624
Author(s):  
Vitalii I. Tsymbaliuk ◽  
Sergii S. Strafun ◽  
Ihor B. Tretyak ◽  
Iaroslav V. Tsymbaliuk ◽  
Alexander A. Gatskiy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Pain Syndrome ◽  
Common Peroneal Nerve ◽  
Combat Trauma ◽  
Diagnostic Measures ◽  
Combat Injuries ◽  
Recovery Of Motor Function ◽  
Degree Of Recovery

The aim: Improving the effectiveness of patients' treatment with combat injuries of the peripheral nervous system, which consists in the application and development of new methods of reconstructive interventions, optimizing a set of therapeutic and diagnostic measures for the most effective management of this category of patients with peripheral nerve injury. Materials and methods: The research is based on the results of surgical treatment of 138 patients with combat injuries of peripheral nerves for the period from 2014 to 2020. The mean age was 33.5 ± 2.1 years. Patients were treated for 1 to 11 months after injury (median – 8 months). Damage to the sciatic nerve was observed in 26.1%, ulnar – in 20.3%, median – in 18.8%, radial – in 15.9%, tibial – in 10.9%, common peroneal nerve – in 8% of cases. Results: It was shown that in all patients was significantly improved the recovery of all nerves. In the period from 9 to 12 months, the degree of recovery of motor function to M0-M2 was observed in 40.6%, to M3 – in 35.5%, to M4 – in 16.7%, to M5 – in 7,2%. The degree of recovery of sensitivity to S0-S2 was observed in 36.2%, to S3 – in 42.8%, to S4 – in 17.4%, to S5 – in 3.6%. Regression of pain syndrome after surgery was observed in 81.2% of patients. Conclusions: The results of surgical treatment of peripheral nerves gunshot injury are generally worse than other types of nerve injuries. The best results of surgical treatment of combat trauma of peripheral nerves are obtained in patients with sciatic nerve damage.

scholarly journals Sciatic neuropathy: findings on magnetic resonance neurography

2017 ◽  
Vol 50 (3) ◽  
pp. 190-196 ◽  
Author(s):  
Paulo Moraes Agnollitto ◽  
Marcio Wen King Chu ◽  
Marcelo Novelino Simão ◽  
Marcello Henrique Nogueira-Barbosa
Keyword(s):  
Magnetic Resonance ◽  
Sciatic Nerve ◽  
Diagnostic Imaging ◽  
Peripheral Nerves ◽  
Lower Limbs ◽  
Detailed Knowledge ◽  
Magnetic Resonance Neurography ◽  
Sciatic Neuropathy ◽  
Common Causes ◽  
Long Course

Abstract Injuries of the sciatic nerve are common causes of pain and limitation in the lower limbs. Due to its particular anatomy and its long course, the sciatic nerve is often involved in diseases of the pelvis or leg. In recent years, magnetic resonance neurography has become established as an important tool for the study of peripheral nerves and can be widely applied to the study of the sciatic nerve. Therefore, detailed knowledge of its anatomy and of the most prevalent diseases affecting it is essential to maximizing the accuracy of diagnostic imaging.

Tactics of surgical treatment of traction injury of sciatic nerve combined with fracture of femur

2018 ◽  
Vol 16 (7(part 1)) ◽  
pp. 77-80
Author(s):  
A. A. Bogov ◽  
◽  
V. G. Ignatyev ◽  
M. R. Zhuravlev ◽  
I. G. Khannanova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Traction Injury

Prevention of painful neuromas by oblique transection of peripheral nerves

2006 ◽  
Vol 104 (2) ◽  
pp. 285-289 ◽  
Author(s):  
Wieslaw Marcol ◽  
Katarzyna Kotulska ◽  
Magdalena Larysz-Brysz ◽  
Grazyna Bierzyñska-Macyszyn ◽  
Pawel Wlaszczuk ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Traditional Method ◽  
Healing Process ◽  
Nerve Transection ◽  
Proximal Stump ◽  
Sciatic Nerves ◽  
Neuroma Formation

Object Neuroma formation often occurs at the proximal stump of the transected nerve, complicating the healing process after gap injuries or nerve biopsies. Most such neuromas cause therapy-resistant neuropathic pain. The purpose of this study was to determine whether oblique transection of the proximal stump of the sciatic nerve can prevent neuroma formation. Methods The sciatic nerves of 10 rats were transected unilaterally at an angle of 30°, and the peripheral segments of the nerves were removed. In 10 control animals the sciatic nerves were transected at a perpendicular angle. Twenty weeks after surgery the nerves were reexposed and collected. The presence of neuromas was determined by two board-certified pathologists on the basis of histopathological evaluations. Conclusions The oblique transection of peripheral nerves, contrary to perpendicularly transected nerves, is rarely followed by classic neuroma development. Moreover, neuropathic pain is significantly reduced compared with that following the traditional method of nerve transection.

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