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Chinese Association for the Study of Pain:Experts consensus on ultrasound-guided injections for the treatment of spinal pain in China(2020 edition)

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World Journal of Clinical Cases 2021年第9期9卷 2047-2057页

作者： Yun Wang Ai-Zhong Wang Bai-Shan Wu Yong-Jun Zheng Da-Qiang Zhao Hui Liu Hua Xu Hong-Wei Fang Jin-Yuan Zhang Zhi-Xiang Cheng Xiang-Rui Wang Department of Anesthesiology Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China Department of Anesthesiology The Sixth Affiliated People's HospitalShanghai Jiao Tong UniversityShanghai 200233China Department of Algology Xuanwu HospitalCapital Medical UniversityBeijing 100053China Department of Algology Huadong Hospital Affiliated to Fudan UniversityShanghai 200040China Department of Anesthesiology Jiahui International HospitalShanghai 200233China Department of Algology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Anesthesiology Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 200437China Department of Algology East HospitalTongji UniversityShanghai 200120China Department of Algology The Second Affiliated HospitalNanjing Medical UniversityNanjing 210011Jiangsu ProvinceChina

spinal pain(SP)is a common condition that has a major negative impact on a patient’s quality of *** developments in ultrasound-guided injections for the treatment of SP are increasingly being used in clinical *** clinical expert consensus describes the purpose,significance,implementation methods,indications,contraindications,and techniques of ultrasound-guided *** consensus offers a practical reference point for physicians to implement successfully ultrasound-guided injections in the treatment of chronic SP.

关键词： spinal pain Ultrasound-guided injections Facet joints spinal nerve roots Posterior spinal nerve Experts consensus

A novel extradural nerve transfer technique by coaptation of C4 to C5 and C7 to C6 for treating isolated upper trunk avulsion of the brachial plexus

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The Journal of Biomedical Research 2018年第4期32卷 298-304页

作者： Kaixiang Yang Shaohua Zhang Dawei Ge Tao Sui Hongtao Chen Xiaojian Cao Department of Orthopaedics the First Affiliated Hospital of Nanjing Medical University

The study aimed to demonstrate the feasibility of an extradural nerve anastomosis technique for the restoration of a C5 and C6 avulsion of the brachial *** fresh frozen human cadavers were *** diameters,sizes,and locations of the extradural spinal nerve roots were *** lengths of the extradural spinal nerve roots and the distance between the neighboring nerve root outlets were measured and compared in the cervical *** the spinal canal,the ventral and dorsal roots were separated by the dura and *** ventral and dorsal roots of C7 had sufficient lengths to anastomose those of *** ventral and dorsal of C4 had enough length to be transferred to those of C5,*** feasibility of this extradural nerve anastomosis technique for restoring C5 and C6 avulsion of the brachial plexus in human cadavers was demonstrated in our anatomical study.

关键词： brachial plexus nerve transfer spinal nerve roots extradural anastomosis surgical feasibility study

Extradural contralateral S1 nerve root transfer for spastic lower limb paralysis

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The Journal of Biomedical Research 2023年第5期37卷 394-400页

作者： Jiang Cao Jie Chang Chaoqin Wu Sheng Zhang Binyu Wang Kaixiang Yang Xiaojian Cao Tao Sui Department of Orthopedics the First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Department of Orthopedics the Second Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China.

The current study aims to ascertain the anatomical feasibility of transferring the contralateral S1 ventral root(VR)to the ipsilateral L5 VR for treating unilateral spastic lower limb *** formalin-fixed(three males and three females)cadavers were *** VR of the contralateral S1 was transferred to the VR of the ipsilateral *** sural nerve was selected as a bridge between the donor and recipient *** number of axons,the cross-sectional areas and the pertinent distances between the donor and recipient nerves were *** extradural S1 VR and L5 VR could be separated based on anatomical markers of the dorsal root *** gross distance between the S1 nerve root and L5 nerve root was 31.31(±3.23)mm in the six cadavers,while that on the diffusion tensor imaging was 47.51(±3.23)mm in 60 patients without spinal diseases,and both distances were seperately greater than that between the outlet of S1 from the spinal cord and the *** numbers of axons in the S1 VRs and L5 VRs were 13414.20(±2890.30)and 10613.20(±2135.58),*** cross-sectional areas of the S1 VR and L5 VR were 1.68(±0.26)mm2 and 1.08(±0.26)mm2,*** conclusion,transfer of the contralateral S1 VR to the ipsilateral L5 VR may be an anatomically feasible treatment option for unilateral spastic lower limb paralysis.

关键词： paralysis spinal nerve roots nerve transfer ankle joint

Pre-operative electrodiagnostic studies and intraoperative neurophysiologic monitoring:power and pitfalls

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Plastic and Aesthetic Research 2023年第1期10卷 561-580页

作者： Erik J.Kobylarz Jason Randhawa Stephen Mason Victoria H.Lawson Department of Neurology Dartmouth-Hitchcock Medical CenterLebanonNH 03756USA Geisel School of Medicine Dartmouth CollegeHanoverNH 03755USA Thayer School of Engineering Dartmouth CollegeHanoverNH 03755USA

Outpatient electrodiagnostic studies and intraoperative monitoring are essential tools for the surgical management of nerve *** are based on the diagnostic certainty afforded by outpatient electrodiagnostic studies,which are more sensitive and specific than clinical examinations regarding the nature and localization of a nerve *** neurophysiologic monitoring detects changes in neurologic function during *** provides significantly better information than visual inspection of the operative field,minimizing postoperative neurologic deficits due to surgical manipulation(e.g.,stretching,compression,heating from electrocauterization,constriction,or clamping of local blood vessels).These techniques exploit similar neurophysiologic principles to afford enhanced diagnostic and real-time functional data during ***,an understanding of their limitations is critical for the interpretation of these *** review discusses these techniques,including their use,advantages,and disadvantages in diagnosing and managing three essential nerve lesions amenable to surgical management-radiculopathy,mononeuropathy,and brachial plexopathy.

关键词： Intraoperative neurophysiologic monitoring(IONM) electromyography(EMG) peripheral nerves spinal nerve roots brachial plexus pedicle screws radiculopathy brachial plexopathy mononeuropathy

Effect of fetal spinal cord graft with different methods on axonal pathology after spinal cord contusion

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Chinese Journal of Traumatology 2001年第3期4卷 147-151页

作者：张强廖维宏王正国伍亚民 Orthopedic Center of PLA 88th Hospital of Jinan Military Command Tai'an 271000 China.

Objective: To investigate the effect of fetal spinal cord (FSC) graft with different methods on axonal pathology and neurological function recovery after spinal cord injury (SCI). Methods: Forty Wistar rats were divided into 4 groups. In Group A, the spinal cord was injured and hemisected. In Group B, fetal spinal cord (FSC) was transferred into the injured site. In Group C, after having done as Group B, the upper and lower spinal nerve roots were anastomosed. And in Group D, after having done as Group B, the pedicled omentum was transferred into the hemisection cavity. At 6 weeks after operation, light and electronic microscopes were used to examine the axonal pathology. The neurological function was assessed with inclined plane tests in the open field. The number of axons was quantitated by a computer image analysis system. Results: A greater loss of axons was observed in Group A than that of other groups at 6 weeks. The sequence of the reduced rate of the axons was as following, Group A>Group B>Group C>Group D (P< 0.05 ). The remaining axons were paralleled with the significant improvement in neurological function recovery of the rats. Conclusions: It indicates that FSC and pedicled omentum grafts after SCI can protect the axons and promote the neurological function recovery of the rats.

关键词： spinal cord injuries Embryo transfer Omentum spinal nerve roots Axons

Electrophysiological monitoring and identification of neural roots during somatic-autonomic reflex pathway procedure for neurogenic bladder

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Chinese Journal of Traumatology 2005年第2期8卷 74-76页

作者：代成甫肖传国 Department of Orthopedic Surgery Shenzhen People's Hospital Jinan University School of Medicine Guangdong 518020 China Department of Urology Tongji Medical College Xiehe Hospital Huazhong University of Science and Technology Hubei China

OBJECTIVE: To identify and separate the ventral root from dorsal root, which is the key for success of the artificial somatic-autonomic reflex pathway procedure for neurogenic bladder after spinal cord injury (SCI). Here we report the results of intra-operating room monitoring with 10 paralyzed patients. METHODS: Ten male volunteers with complete suprasacral SCI underwent the artificial somatic-autonomic procedure under general anesthesia. Vastus medialis, tibialis anticus and gastrocnemius medialis of the left lower limb were monitored for electromyogram (EMG) activities resulted from L4, L5, and S1 stimulation respectively to differentiate the ventral root from dorsal root. A Laborie Urodynamics system was connected with a three channel urodynamic catheter inserted into the bladder. The L2 and L3 roots were stimulated separately while the intravesical pressure was monitored to evaluate the function of each root. RESULTS: The thresholds of stimulation on ventral root were 0.02 ms duration, 0.2-0.4 mA, (mean 0.3 mA+/-0.07 mA), compared with 0.2-0.4 ms duration, 1.5-3 mA (mean 2.3 mA+/-0.5 mA) for dorsal root (P

关键词： Reflex Adult Autonomic Pathways Bladder Bladder, Neurogenic Electric Stimulation Therapy Electromyography Electrophysiology Humans Male Muscle Contraction Muscle, Skeletal Muscle, Smooth spinal Cord Injuries spinal nerve roots Thigh