Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SACRAL PLEXUS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

[Magnetic resonance myelography. Preliminary experience].

Three-dimensional (3D) MR Myelography is a new technique using constructive interference steady-state (CISS) sequences, which are characterized by a symmetric flow compensation enhancing CSF signal intensity compared with neural and extradural structures. 3D myelographic projections with different rotation angles are obtained from the 3D dataset with a mathematical algorithm called maximum intensity projection (MIP). Myelographic projections yield a global view of subarachnoid spaces and of root sleeves with no intrathecal contrast agent injection. This study was aimed at assessing the feasibility, the clinical value and the diagnostic accuracy of 3D MR Myelography in comparison with conventional myelography. From September 1992 to January 1994, thirty-five myelograms were performed. The study population consisted of 10 volunteers, 8 patients with traumatic brachial plexus lesions, 7 with herniated disks (4 lumbar and 3 cervical disks), 4 with sacral radicular cysts, 2 with spinal vascular malformations, 3 with extramedullary intradural neoplasms (2 cervical neuromas and 1 cervical meningioma) and 1 with an intramedullary tumor (a conus medullaris ependymoma). All patients underwent SE MRI and conventional myelography (22 lumbar injections, 3 cervical injections of nonionic iodinated contrast agent) followed by CT (CT myelography). This trial demonstrates the feasibility of 3D MR myelography in the study of the cervical and lumbar spine: its results are comparable to those obtained with conventional myelography also in some specific indications like traumatic brachial plexus injuries, where invasive conventional myelography is usually thought to be essential.

Algorithms↗
PubMed1993

[Morphometric study of the lumbosacral plexus innervating the muscles of the rat pelvic floor].

Motoneurons of the pelvic muscles in the lumbo-sacral segment of the spinal cord have been extensively studied in different species. However, few informations occur in the literature about the individual morphology of each group of neurons and their connections. Thus, in the Rat we have studied the neuronal mapping of 5 pelvic muscles, bulbospongiosus, ischio-cavernosus, levator ani, sphincter ani, sphincter urethrae, using a retrograde tracer, the horseradish peroxidase (H.R.P.). Most of the muscles injected by H.R.P. receive their innervation from the motoneurons located in the homolateral side of the spinal cord. The motoneurons of sphincter ani (+/- 40) and those of the bulbo-spongiosus (+/- 50) have the same morphology. Their dendrites contact contralateral motoneurons. They are situated in the dorso-medial nucleus of the L5-L6 segments of the spinal cord. The motoneurons of the ischio-cavernosus (+/- 80) and those of sphincter urethrae (+/- 40) are situated in the dorsolateral nucleus of the L5-S1 segments of the spinal cord where they form two distinct groups. On the contrary, in the ventro-medial nucleus, the neurons are mixed. The dendrites in the dorso-lateral nucleus form an important longitudinal network. The motoneurons of the levator ani (+/- 50) are situated in the ventral nucleus of the L5-S1 segments. Our works demonstrate the significance of the dendritic networks: they could play a role in the synchronization and the activity of the pelvic muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1999

Regional differences in the sympathetic innervation of the guinea pig large intestine by neuropeptide Y- and tyrosine hydroxylase-immunoreactive nerves of divergent extrinsic origin.

Region-specific patterns of nerves with immunoreactivity to neuropeptide Y (NPY) have been described previously in the submucous plexus of guinea pig large intestine. Because these may have functional significance, the possibility of similar, characteristic variations of NPY-like immunoreactivity (NPY-ir) in the myenteric plexus was explored. Regional differences were found in the occurrence and pattern of distribution of NPY-ir in the myenteric plexus of the guinea pig large intestine. NPY-ir was present rarely within neuron somata in any region of the large intestine, and NPY-ir nerve fibers were present only within the distal large intestine, increasing progressively in density from the distal spiral to the rectum. Lesion of the colonic nerves, but not the hypogastric, intermesenteric, or lumbar splanchnic nerves, resulted in a loss of NPY-ir in the distal spiral and transverse colon but not in the descending colon or rectum. Ring myotomies in the descending colon resulted in a loss of NPY-ir proximal to the lesion. Dual-labeling immunohistochemical studies revealed that the NPY-ir nerve fibers rarely contained immunoreactivity for tyrosine hydroxylase (TH). Extrinsic nerve lesions resulted in an unequivocal reduction in NPY-ir in intraganglionic fibers of the submucosal plexuses of the transverse colon and a partial loss in the distal spiral and descending colon: the rectum was unaffected; in only a minority of guinea pigs, however, was any decrease in the NPY-ir innervation of submucosal blood vessels detected. The principal projections of NPY-ir nerves were from and through the inferior mesenteric ganglion; however, NPY-ir was not colocalized with TH-ir. It is proposed that nonnoradrenergic, NPY-containing neurons located in the inferior mesenteric ganglion project through the colonic nerves and that these proximally directed fibers innervate the transverse colon and the distal spiral. Nonnoradrenergic, NPY-ir neurons lying in the pelvic ganglia or sacral sympathetic chain may make an important contribution to the innervation of the myenteric plexus of the rectum and the descending colon.

Animals↗
PubMedDate not supplied

Operative treatment of a transverse fracture-dislocation at the S1-S2 level.

SUMMARY: The authors recently treated a multiply injured patient who sustained a rare fracture-dislocation at the S1-S2 level. The S1 vertebra was displaced forward into the pelvic cavity and was located just in front of the S2 vertebra. Because the patient also had extensive neurologic injury to the lumbar plexus and instability of the pelvic ring, operative treatment was deemed necessary. Surgery to stabilize the pelvis and decompress the lumbar plexus proved successful, and the patient experienced marked improvement in her postoperative neurologic function. Nonoperative treatment has traditionally been recommended for this injury, but advances in spinal surgery have made transverse sacral fractures more amenable to open reduction and fixation. Potential benefits of this operative treatment include relief of pressure from the lumbar plexus, a stable pelvis and facilitation of return of neurologic function.

Adult↗
PubMed1996

Fecal incontinence after pelvic radiotherapy: evidences for a lumbosacral plexopathy. Report of a case.

PURPOSE: Clinical manifestations of radiation-induced lumbosacral plexopathy remain a rare event. We report the case of a 62-year-old woman with neurogenic fecal incontinence that occurred after radiotherapy of cervical carcinoma. METHODS: Anorectal, bladder, and lower limb sensory-motor functions, as biologic and morphologic explorations, were performed on repeated occasions. RESULTS: Anorectal manometry, conduction times of pudendal nerves, sacral latencies, and pudendal nerve-evoked corticals disclosed lesions of the lumbosacral plexus that was confirmed by bladder manometry and electromyography of lower limbs. Biologic and morphologic explorations were within normal ranges. CONCLUSION: Because no other cause except radiation was demonstrated in this case, we suggest that plexopathy may be a late-occurring complication of radiotherapy.

Brachytherapy↗
PubMed2003

"Mesorectum": the surgical value of an anatomical approach.

The quality of total extirpation of the "mesorectum" nowadays determines the prognosis of rectal cancer but the planes of surgical dissection which have been proposed and the anatomical restrictions of this "mesorectum" are sometimes contradictory. The aim of this study was to clarify the relationships of the "mesorectum" with the fascias and nerves of the pelvic cavity to harmonize the plane of dissection in its total extirpation. Four pelvises (2 male, 2 female) harvested from embalmed cadavers were studied by dissection and anatomico-imaging correlation. Two pelvises (1 male, 1 female) were injected with copolymer via the internal iliac and inferior mesenteric arteries. They were then frozen and sectioned sagittally into two hemi-pelvises for the dissection. The two other pelvises were initially studied in 5 mm cuts with CT scanning and magnetic resonance scanning in the sagittal and "transverse oblique" planes. They were then frozen and then cut sagittally into two hemi-pelvises. Each hemi-pelvis was then cut into anatomical sections with an electric saw similar to the radiological cuts: sagittal cuts on the right hemi-pelvis, and "transverse oblique" cuts on the left hemi-pelvis. It was noted that the "mesorectum" was carpeted behind and laterally by a postero-lateral fibrous envelope belonging to the pelvic visceral fascia and in front by a recto-genital membrane of variable nature corresponding to the "Denonvilliers fascia". The postero-lateral fibrous envelope splits into two leaves (anterior and posterior) in front of the sacral concavity and constitutes, lateral to the rectum, the armature of the pelvic plexus. These two leaves delineated the avascular retro-rectal space. The results of the correlations were deceptive. Their use was limited by dilatation of the rectum, which flattened the perirectal fat onto the pelvic walls on all the sections. Nonetheless, the description of the "mesorectum" and the demonstration of its enveloping fascias by dissection allowed the development of a dissection plane for its total extirpation.

Aged↗
PubMed1990

[Lumbosacral nerve root avulsion. Diagnosis using computed tomography, magnetic resonance tomography and myelography].

Root lesions in the lumbo-sacral region are rare, compared with injuries of the roots of the brachial plexus. They occur almost exclusively in association with serious injuries of the pelvis. The present case, without pelvic injury, is a rarity. The appearances on myelography and CT are well known, but the findings on MRI are also described and the value of this non-invasive procedure is discussed.

Adult↗
PubMed1984

Intrathecal morphine for pelvic and sacral pain caused by cancer.

Ten patients underwent placement of a lumbar subarachnoid catheter attached to a subcutaneous reservoir allowing daily injection of intrathecal morphine sulfate by family members. Sacral and pelvic pain were fairly well controlled. Neck and leg pain and pain mediated by the celiac plexus were not as well controlled by the intrathecal injection of morphine. The only significant complication was collection of cerebrospinal fluid around three reservoirs. Using this technique, narcotic concentration and frequency of administration can be easily altered to provide a safe but effective dose. Lumbar administration appears to block pain from lumbar and sacral dermatomes without the sedating and mood-altering effects of systemic narcotics.

Adult↗
PubMed2026

Predictive value of anal sphincter electromyography for sacral neuromodulation test-phase outcomes.

BACKGROUND: Sacral neuromodulation (SNM) is an established therapy for refractory pelvic organ dysfunction. Anal sphincter electromyography (EMG) is commonly used preoperatively to assess sacral and peripheral nerve integrity. However, the prognostic significance of chronic neurogenic EMG changes for SNM outcomes remains unclear. OBJECTIVE: To evaluate whether chronic neurogenic changes on preoperative anal sphincter EMG predict the outcome of the SNM test phase. METHODS: We retrospectively analysed 62 consecutive patients with bladder and/or bowel dysfunction or pelvic pain who were candidates for SNM treatment and who underwent preoperative anal sphincter EMG. EMG findings were classified as normal or showing chronic neurogenic changes. SNM test-phase success was defined as a ≥50% improvement of symptoms at 24 days. Outcomes were compared between EMG groups. RESULTS: Of the 62 patients (49 women, 13 men), 30 (48%) had normal EMG findings and 32 (52%) showed chronic neurogenic changes. Overall, the SNM test phase was successful in 47 patients (76%). Success rates were similar in patients with normal EMG (72%) and neurogenic EMG changes (79%), with no statistically significant difference (p = 0.878). Sex-stratified analyses revealed no significant association between EMG findings and test-phase success in women or men. CONCLUSIONS: Chronic neurogenic changes on anal sphincter EMG do not predict SNM test-phase outcomes. These findings suggest that abnormal sphincter EMG results should not be used as a standalone criterion to exclude patients from SNM therapy. SIGNIFICANCE: Signs of neurogenic damage on anal sphincter EMG are not an indicator of reduced neuromodulatory capacity or diminished clinical response to SNM.

Humans↗
PubMed1994

The detailed neuroanatomy of the human striated urethral sphincter.

OBJECTIVE: To study the nerve supply of the striated urethral sphincter. MATERIALS AND METHODS: The pelvis from six formalin-fixed male cadavers was dissected. RESULTS: Cadaveric dissection revealed that both the intrinsic and extrinsic segments of the urethral rhabdosphincter receive their innervation from sacral roots S2-S4. The nerve fibres travel to their final destination via both the pudendal nerves and the nerve branches of the sacral roots. The terminal branches of the pudendal nerve enter the sphincteric area from the perineum. They separate shortly after they cross the ischial spine and run further ventromedially. Small branches approach the sphincter after their division from the dorsal nerve of the penis. The course of the pudendal nerve and its branching on the perineum are quite consistent. The pelvic branches travel inside the pelvis above the levator ani muscle. Among the cadavers the number of branches varied markedly, as did their site of termination (2.3 to 3.9 cm from the striated urethral sphincter). A substantial nerve approaching the sphincter from inside the pelvis was found. After it divided from the S2, S3 sacral roots it ran separately, initially just lateral to the fibres of the pelvic plexus and then on the dorsolateral surface of the rectum. In its terminal segment it dived into the levator ani muscle and terminated in the striated urethral sphincter. CONCLUSIONS: We believe that the nerve supply to the striated urethral sphincter consists of branches from both the pudendal nerve and the 'extrapudendal' nerves that run above the levator ani muscle inside the pelvis. The variations in the course of the latter are remarkable.

Humans↗
PubMed2005

Multi-detector row computed tomography angiography in diagnosing spinal dural arteriovenous fistula: initial experience.

BACKGROUND AND PURPOSE: Multi-detector computed tomographic (MDCT) angiography is a recently developed imaging technique that can study small vessels such as medullary arteries and veins. The purpose of this study was to evaluate MDCT angiography in diagnosing SDAVF. METHODS: Eight patients with initial magnetic resonance imaging (MRI) and clinical findings suggestive of spinal dural arteriovenous fistula (SDAVF) and 8 control subjects underwent MDCT angiography. Both MDCT angiography and catheter angiography were performed within 5 days in patients with SDAVFs. The results of MDCT angiography in patients with SDAVFs were compared with those of catheter angiography. RESULTS: MDCT angiography detected engorged perimedullary draining veins and correctly localized the fistula of the SDAVFs, and correlated well with catheter angiography. Fistula was at the thoracic level in 7 patients, and sacral level in 1 patient. MDCT angiography did not visualize the engorged perimedullary venous plexus in the control group. CONCLUSIONS: MDCT angiography correlated well with catheter angiography in diagnosing SDAVFs. It might play a role in shortening the length of the catheter angiography in diagnosing this disease.

Angiography↗
PubMed1978

The transverse lumbosacral back flap.

The transverse lumbosacral back flap is presented as a good one to use for coverage of sacral defects. Its reliability appears to be due to an axial pattern of its proximal portion, and to an uninterrupted subdermal vascular plexus across the midline of the back (supplying the terminal portion). A retrospective analysis of its use in 20 patients, over the last 3 years, suggests that when it is designed properly it can be most useful in the management of sacral pressure sores.

Adolescent↗
PubMedDate not supplied

Trans-femoral lumbar epidural venography.

Epidural venography is a relatively simple, safe and highly accurate method of diagnosing lumbar disc herniations. Good opacification of the epidural venous plexus can be obtained by selective catheterization of the ascending lumbar vein or pre-sacral branches of the internal iliac veins. Experience with 100 cases of lumbar disc herniations is described. The authors think that epidural venography is a more sensitive technique than myelography, particularly with lateral disc herniation at the L5-S1 level. It is not associated with the morbidity or complications of myelography and can be performed as an outpatient procedure. Epidural venography is recommended as the examination of choice in patients with suspected lumbar disc herniation.

Epidural Space↗