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Positions in neurosurgery
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
Zilvinas Zakarevicius, Mikhail Gelfenbeyn, Irene Rozet
Prolonged sitting position can be damaging to the common peroneal and sciatic nerve. As the sciatic nerve crosses both hip and knee joints, to minimize sciatic nerve injury, excessive flexion of the knee and extension of the hip should be avoided (3). The buttock gel pad prevents excessive pressure on the sciatic nerve.
Injuries of the hip and femur
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Richard Baker, Michael Whitehouse
Sciatic nerve injury The sciatic nerve is damaged in 10–20% of cases. Nerve function must be tested and documented before reduction of the hip is attempted. If, after reducing the dislocation, a new onset sciatic nerve lesion is diagnosed, the nerve should be explored to ensure it has not been trapped by the reduction manoeuvre. If a foot drop occurs, the ankle is splinted in a neutral position to prevent an equinus deformity and in order to aid mobilization.
Injuries of the Hip and Femur
Published in Louis Solomon, David Warwick, Selvadurai Nayagam, Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Louis Solomon, David Warwick, Selvadurai Nayagam
In a straightforward case the diagnosis is easy: the leg is short and lies adducted, internally rotated and slightly flexed. However, if one of the long bones is fractured – usually the femur – the injury can be missed. The golden rule (whenever the facilities exist) is to obtain a ‘trauma computed tomography (CT)’ scan which includes the pelvis, the entire femur and the knee in every case of severe injury; and, even with isolated femoral fractures, to insist on x-rays that include the hip and the knee. The lower limb should be examined for signs of sciatic nerve injury.
Effects of Dexamethasone on Bupivacaine-Induced Peripheral Nerve Injection Injury in the Rat Sciatic Model
Published in Journal of Investigative Surgery, 2021
Mehmet Selim Çömez, Yakup Borazan, Tümay Özgür, Cafer Tayer İşler, Mustafa Cellat, Mehmet Güvenç, Muhammed Enes Altuğ
Nerve injury activates the release of inflammatory mediators and increases the ectopic secretion from the nerve, thus contributes to the development of neuropathic pain.29–31 After nerve injury, the administration of a local corticosteroid for neuropathic pain may provide effective treatment depending on the suppression of the ectopic neural releases from the injured nerve.32 Eker et al.11 conducted a study with 5 patients, who had severe and persistent neuropathic pain due to accidental sciatic nerve injury. They evaluated the efficacy of sacral injection of 80 mg methylprednisolone + 1% lidocaine through S1-S2-S3 sacral foramens. They reported almost complete recovery from the neuropathic pain symptoms in all patients after a one-month follow-up.11These authors compared also methylprednisolone acetate + lidocaine and lidocaine monotherapy used for the peripheral nerve block to treat refractory neuropathic pain following the peripheral nerve injury and found that methylprednisolone + lidocaine treatment was superior to the lidocaine monotherapy regarding the decrease the pain intensity, neuropathic symptoms, and findings and need for analgesics.12 An et al.9 stated that perineural dexamethasone could prevent the development of the short-term bupivacaine-mediated rebound hyperalgesia when dmt added to bupivacaine.
PEITC promotes neurite growth in primary sensory neurons via the miR-17-5p/STAT3/GAP-43 axis
Published in Journal of Drug Targeting, 2019
Zhijie Wang, Wenqi Yuan, Bo Li, Xueming Chen, Yanjun Zhang, Chuanjie Chen, Mei Yu, Yucai Xiu, Wenhua Li, Jiangang Cao, Xin Wang, Wen Tao, Xiaoling Guo, Shiqing Feng, Tianyi Wang
Sixty-five adult female Wistar rats were randomly divided into four groups, including the sciatic nerve conditioning injury (n = 20), simple dorsal column lesion (n = 20), simple sciatic nerve injury (n = 20) and sham control (n = 5) groups. In the first three groups, the animals were randomly assigned to four subgroups assessed at 4 h, 3, 7, and 14 d (n = 5), respectively. The sham control group only underwent T10 total laminectomy without injury to the spinal cord. The sciatic nerve conditioning injury group underwent dorsal column injury 1 week after sciatic nerve conditioning injury. The simple dorsal column lesion group underwent dorsal column injury simultaneously with the sciatic nerve conditioning injury group. The simple sciatic nerve injury group only underwent sciatic nerve injury simultaneously with the sciatic nerve conditioning injury group. Rats in the sciatic nerve conditioning injury, simple sciatic nerve injury and simple dorsal column lesion groups were sacrificed at 4 h, 3, 7, and 14 d post dorsal column lesion.
Factors influencing MR changes associated with sacral injury after high-intensity focused ultrasound ablation of uterine fibroids
Published in International Journal of Hyperthermia, 2019
Jiang-ping Cun, Hong-jie Fan, Wei Zhao, Gen-fa Yi, Yong-neng Jiang, Xuan-cheng Xie
Safety is always a sensitive topic in the USgHIFU ablation of uterine fibroids. In accordance with the Society of Interventional Radiology (SIR) classification system for complications by outcome [14], in a total of 305 AEs in 346 patients, 229 out of 305 (75.1%) AEs were classified as Class A, which recovered spontaneously within three days. In addition, 71 of 305 (23.3%) AEs subsided within 1 week without any specific treatment and thus these were classified as grade B. One patient with surgical scars reported second-degree burns in the group without injury; these were classified as Class C because the burnt area necessitated resection. Two patients reported leg pain after treatment because of a temporary sciatic nerve irritation. The pain lasted for 3 months and NSAIDs for pain control were suggested, so this was established as Class D. Sciatic nerve irritation was only observed in the injury group. This could be explained by fibroid features and the treatment parameters. The use of too much water with a degassed water balloon or overfilling the bladder may also have played a role in the sciatic nerve injury. With increased experience and a safe distance between the fibroid and the sacral surface, the rate of sciatic nerve injury could be reduced further. However, the incidence of other AEs, including fever, bowel injury, nausea or vomiting, bladder injury or urinary retention were rare when compared to previous studies [16,23]. Therefore, USgHIFU is considered to be a safe and promising treatment for uterine fibroids.