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Designing for Lower Torso and Leg Anatomy
Published in Karen L. LaBat, Karen S. Ryan, Human Body, 2019
Meralgia paresthetica is a relatively common purely sensory nerve compression in the lower extremity. It involves the lateral femoral cutaneous nerve of the thigh (refer to Figure 5.19), a branch of the lumbar plexus. The compression site is in the groin, medial to the ASIS. Symptoms may include numbness, tingling, and discomfort over the lateral thigh, from the trochanter to the knee. Tight products: jeans, military armor, police uniforms, and seat belts have all been associated with this problem (Cheatham, Kolber, & Salamh, 2013). Pressure on the common fibular nerve at the fibular head, such as from a poorly fitting AFO, can compromise both motor and sensory components of the nerve (Rigoard, 2017). A tibial nerve compression site is located distally behind and below the medial malleolus at the tarsal tunnel. Compression at the site may lead to sensory disturbances of the heel and/or sole of the foot and weakness in the foot muscles. For additional information read Section 8.5.1. The tarsal tunnel syndrome is rare compared to the more familiar carpal tunnel syndrome at the wrist (discussed in Chapter 7). Wearable products for carpal tunnel syndrome abound, few if any wearable products are available for the rarer lower leg problem (McSweeney & Cichero, 2015).
Device profile of the FlareHawk interbody fusion system, an endplate-conforming multi-planar expandable lumbar interbody fusion cage
Published in Expert Review of Medical Devices, 2023
Peter B. Derman, Rachelle Yusufbekov, Brian Braaksma
Anterior lumbar interbody fusion (ALIF), lateral lumbar interbody fusion (LLIF), and oblique lumbar interbody fusion (OLIF) tend to utilize large-footprint cages inserted through a retroperitoneal approach. However, these procedures carry inherent risk to visceral and vascular structures, the lumbar plexus, and the sympathetic chain; and they may therefore require an access surgeon [2]. While these large cages are able to improve disc height and lordosis, as well as provide a large surface area for endplate coverage and bone graft delivery, additional posterior surgery is still necessary if direct decompression of the neural elements and/or supplemental posterior fixation is required. This may require intra-operative patient repositioning or operating in a non-intuitive orientation in an effort to increase operating room efficiency by avoiding a ‘flip.’
Current devices used for the monitoring of injection pressure during peripheral nerve blocks
Published in Expert Review of Medical Devices, 2018
While we await outcomes data from the large registries of PNBs, there are three other interesting potential applications of this technology that deserve investigation. One is the effect of using injection pressure monitoring to prevent inadvertent spread of local anesthetic. The hypothesis is that excessive injection pressure will force local anesthetic into spaces or fascial planes. This has been shown in both a lumbar plexus and interscalene brachial plexus block model, as described above [14,15]. There are clinical consequences to inadvertent spread of local anesthetics to other (e.g. epidural) spaces, and it appears that limitation of injection pressure for these reasons is both useful and prudent.
The biomechanical study of a modified lumbar interbody fusion—crenel lateral interbody fusion (CLIF): a three-dimensional finite-element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Yun-lin Chen, Ou-jie Lai, Yang Wang, Wei-hu Ma, Qi-xin Chen
The lateral lumbar interbody fusion (LLIF) is a minimal invasive procedure to treat multiple degenerative spinal diseases including lumbar disc herniation, lumbar canal stenosis, lumbar spondylolisthesis and degenerative scoliosis. LLIF was introduced by Ozgur firstly (Ozgur et al. 2006). The advantages of LLIF include less blood loss, large cage placement and indirectly decompression without violating the lumbar canal and so on. However, LLIF also has the risk of neurologic, vascular and visceral injury, including the lumbar plexus, genitofemoral nerve, vena cava, aorta and colon.