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Different time-courses of i.v. lidocaine effect on ganglionic and spinal units in neuropathic rats.

The effect of intravenous lidocaine (4 mg kg-1) on ganglionic and spinal neuronal hyperactivity following sciatic chronic constriction injur … rse of the inhibitory effects were highly comparable in dorsal horn neurones before and after acute rhizotomy. The results indicate that peripheral and central effects of lidocaine are not sequentially related. The likelihood that lidocaine inhibition at central sites may have a role in its analgesic effect, at least in the neuropathic model, is discussed.

The contribution of the dorsal and ventral roots of the tibial nerve in the propagation of the spinal somatosensory evoked potential in cats.

This study employed selective unilateral dorsal and ventral rhizotomy to examine the contribution of both the dorsal and ventral roots of the tibial nerve in the induction of the spinal somatosensory evoked potential (SSEP) in the cat. The spinal roots of origin of the tibial nerve in the cat were determined by retrograde transport of horseradish peroxidase (HRP). Spinal roots L6, L7, and S1 were found to give rise to the cat tibial nerve. Physiologic monitoring showed that the dorsal roots at these levels primarily contribute to the induction of the SSEP, but the ventral roots also make a sma…

Acute effect of anhydrous glycerol on peripheral nerve: an experimental study.

Percutaneous retrogasserian glycerol rhizotomy has shown encouraging results in the treatment of trigeminal neuralgia. An experimental study was undertaken using a rat sciatic nerve model to elucidate the mechanism of action of anhydrous glycerol and to study the acute changes which develop within one week. Extraneural glycerol was applied in 20 adult Wistar rats. Groups of five animals were sacrificed at days 1, 3, 5 and 7 respectively. The sciatic nerve of the opposite limb in the same animals was used as a control. The nerve were examined with light and electron microscopy including a morph…

Repeat radiosurgery for refractory trigeminal neuralgia.

OBJECTIVE: Stereotactic radiosurgery has become an important and minimally invasive alternative for patients with refractory trigeminal neur … undergone multiple previous operations of other types (microvascular decompression, radiofrequency rhizotomy, glycerol rhizotomy, balloon compression). The median target doses of the first and second radiosurgeries were 75 and 64 Gy, respectively. All patients were evaluated by a physician who did not participate in patient treatment. RESULTS: After the f …

BEST PAPER Gait and Clinical Motion Analysis Society meeting 2024: The prevalence and risk factors associated with anterior pelvic tilt in ambulatory youth with cerebral palsy.

BACKGROUND: Excessive anterior pelvic tilt (APT) in youth with cerebral palsy (CP) may be associated with back pain and functional limitatio … 9° anterior at visit 2 in both the surgery and no surgery groups (p = 0.63). Prior selective dorsal rhizotomy, older age, and medial+lateral hamstring lengthening (HL) were significant factors associated with increases in APT; Achilles lengthening, higher gross motor function score, and high APT at visit 1 were protective. The mean change in pelvic tilt aft …

Frameless image-guided linear accelerator (LINAC) stereotactic radiosurgery for medically refractory trigeminal neuralgia: Clinical outcomes in 116 patients.

BACKGROUND: Frameless image-guided radiosurgery (IGRS) is an effective and non-invasive method of treating patients who are unresponsive to … months. Most patients (81 [69.8%]) had not undergone surgery (microvascular decompression [MVD] or rhizotomy) or stereotactic radiosurgery (SRS) for TN before frameless IGRS. A total of 41 (35.3%) patients underwent a salvage procedure (MVD, rhizotomy, or an additional IGRS) following frameless IGRS. The mean duration between the initial frameless IGRS and …

Posterior fossa reexploration for persistent or recurrent trigeminal neuralgia or hemifacial spasm: surgical findings and therapeutic implications.

OBJECTIVE: To evaluate the surgical findings and subsequent therapeutic implications of posterior fossa reexploration for persistent or recu … er sources of root irritation were appreciated in 61% of reexplorations. Partial sensory trigeminal rhizotomy was performed in 83% of reexplorations for persistent or recurrent TN. Of eight patients undergoing reexploration for persistent or recurrent HFS, six sustained complications. CONCLUSION: Recurrent vascular compression was seldom identified during …

Recurrent trigeminal neuralgia following MVD: a meta-analysis of second-line treatment strategies.

OBJECTIVE: This study aimed to compare pain outcomes and complication rates between reexploration microvascular decompression (MVD), percutaneous rhizotomy (PR), and stereotactic radiosurgery (SRS) as second-line treatments for recurrent or persistent trigeminal neuralgia (TN) following an initial MVD. METHODS: A systematic review and meta-analysis was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-Analysis of Observational Studies in Epidemiology) guidelines. Studies were included if they reported outcomes of reexplora…

Repeat Surgery for Recurrent or Refractory Trigeminal Neuralgia: A Systematic Review and Meta-Analysis.

OBJECTIVE: Surgery can effectively treat Trigeminal neuralgia (TN), but postoperative pain recurrence or nonresponse are common. Repeat surgery is frequently offered but limited data exist to guide the selection of salvage surgical procedures. We aimed to compare pain relief outcomes after repeat microvascular decompression (MVD), percutaneous rhizotomy (PR), or stereotactic radiosurgery (SRS) to determine which modality was most efficacious for surgically refractory TN. METHODS: A PRISMA systematic review and meta-analysis was performed, including studies of adults with classical or idiopath…

Neuronavigated percutaneous gasserian radiofrequency thermorhizotomy for trigeminal neuralgia: how I do it.

BACKGROUND: Radiofrequency thermorhizotomy (TRZ) is an established treatment for trigeminal neuralgia (TN). TRZ can result risky and painful in a consistent subset of patients, due to the need to perform multiple trajectories, before a successful foramen ovale cannulation. Moreover, intraoperative x-rays are required. METHOD: TRZ has been performed by using a neuronavigated stylet, before trajectory planning on a dedicated workstation. CONCLUSION: Navigated-TRZ (N-TRZ) meets the expectations of a safer and more tolerable procedure due to the use of a single trajectory, avoiding critical stru…

Cerebral Palsy: Current Concepts and Practices in Musculoskeletal Care.

Cerebral palsy is a neurologic disorder characterized by a spectrum of motor and cognitive deficits resulting from insults to the developing … including medications, botulinum toxin injections, intrathecal baclofen pumps, and selective dorsal rhizotomy. Orthopedic interventions are indicated for symptomatic or progressive musculoskeletal sequelae. Treatments for dysplastic hips and/or hip instability range from soft tissue releases to bony procedures. Neuromuscular scoliosis is managed with poster …

Advances in the management of trigeminal neuralgia.

Trigeminal neuralgia (TN), one of the most intense forms of facial pain, has been the subject of great clinical interest. Significant advances have been made in its management, including surgical treatment and imaging of the trigeminal nerve and associated neurovascular compression. The different options for surgical treatment, recent advances in each as well as novel methods of imaging of the trigeminal nerve focusing on diffusion tensor imaging/tractography will be discussed.

Ортопедический взгляд на управление Спастисти.

Нейрологическое состояние, такое, как травмы мозга, церебральный паралич, инсульт и множественный склероз, влечет за собой повреждения верхних моторных нейронов, которые могут проявляться как спастичность. В результате гипертоничность и диспропорция сил между мышечными группами приводят к деформациям, которые ухудшают функции пациента и могут вызывать значительные долгосрочные осложнения. Симптомы спастисти могут быть устранены с помощью таких неоперабельных методов, как физиотерапия, скачки или лекарства. Другие подходы, такие, как интратективные баклофеновые насосы и селективная дорсальная р

Совпадение в аннотации оригинала
Neurologic conditions such as brain injuries, cerebral palsy, stroke and multiple sclerosis involve injury of upper motor neurons, which can … , bracing, or medications. Other approaches such as intrathecal baclofen pumps and selective dorsal rhizotomy have also demonstrated efficacy in controlling spasticity. Spasticity that has failed nonoperative management can be treated with orthopedic surgeries that correct deformities by either restoring joint anatomy or re-balancing the forces of spastic m …

Sudden Death Due to Necrotizing Fasciitis After Routine Cervical Radiofrequency Ablation Treatment.

Cervical facet joint neurotomy, also known as cervical radiofrequency ablation (RFA) or cervical facet rhizotomy, is a medical procedure aimed at alleviating chronic neck pain caused by issues related to the cervical facet joints through ablation of neurons ( J Pain Res 2021;14:2807-2831). Although generally safe, adverse events can occur. Infection is a rare consequence of this procedure. Most injection-site infections related to cervical RFA occur spontaneously and resolve with oral antibiotics without sequelae ( World Neurosurg 2018;111:e644-e648). We report a case in which a cervical RFA i…

[Diagnosis and treatment of trigeminal neuralgia].

Trigeminal neuralgia is a disease affecting older individuals. The clinical hallmark of trigeminal neuralgia is a sudden, excruciating paroxysm of pain in the area of the trigeminal nerve. Drug therapy is considered the first line of treatment for trigeminal neuralgia. Anticonvulsant carbamazepine has been used. If relevant pharmacotherapy has been tried without any effect, other procedures are selected. These procedures are microvascular decompression(a radical technique), glycerol trigeminal rhizotomy, percutaneous trigeminal nerve decompression and nerve block. Nerve block with neurolytic s…

Electrophysiological evidence for afferent nerve fibers in human ventral roots.

This study was designed to test the hypothesis that ventral roots in humans contain afferent nerve fibers. We made direct electrophysiological recordings of compound nerve action potentials in dorsal and ventral roots in children undergoing selective dorsal rhizotomy for spastic cerebral palsy. We stimulated the saphenous or sural nerves, which are pure sensory nerves, with electrical stimuli while systematically recording from ventral and dorsal roots from L3 to S2. In addition to the dorsal root nerve action potentials which we expected, we found smaller compound nerve action potentials, whi…

Muscle Tone Assessment under General Anesthesia for Sjögren-Larsson Syndrome and Spasticity.

INTRODUCTION: Study of muscle tone in individuals with severe spasticity (Modified Asworth Scale - MAS:3) under general anesthesia can confirm or rule out the eventual necessity of the impending spasticity relieving ablative neurosurgery by observing the hypertonia reduction and passive range of motion expansion. Therefore, what we measure under muscle relaxants is practically a fixed deformity. CASE PRESENTATION: The study was performed on a girl with Sjögren-Larsson syndrome, presenting with icthyosis and spastic diplegia. Proposed intervention was Dorsal Rhizotomy. Under general anesthesia…

Renal Sympathetic Denervation in Rats.

Experimental renal sympathetic denervation is a well-established technique. Classically, renal sympathetic denervation is achieved by dorsal rhizotomy. While more recently, direct renal sympathetic denervation is typically applied by stripping all visible renal nerve bundles followed by painting with a solution of 10 % phenol in ethanol to remove the remaining nerves. In clinical settings, a reliable marker of renal sympathetic denervation or renal sympathetic overactivity has not been established. However, in experimental models, successful renal sympathetic denervation is validated by a decr…

Dorsal root ganglionectomy for intractable monoradicular sciatica. A series of 61 patients.

Dorsal root ganglionectomy was introduced in 1975 as a procedure with theoretical advantages over dorsal rhizotomy for the treatment of intractable radicular pain. Results of the few clinical reports have been generally favorable. The authors report the largest and most comprehensively studied series to date. 61 patients (33 men, 28 women) underwent dorsal root ganglionectomy for intractable sciatica, most often monoradicular. Patients were selected for surgery only if the clinical history, physical examination, radiologic studies, and diagnostic radicular block all predicted a favorable outco…