geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Diffusion-weighted magnetic resonance (DW-MR) neurography of the lumbar plexus in the preoperative planning of lateral access lumbar surgery


, : Diffusion-weighted magnetic resonance (DW-MR) neurography of the lumbar plexus in the preoperative planning of lateral access lumbar surgery. European Spine Journal 24(4): 817-826

Magnetic resonance (MR) neurography has been used to evaluate entire nerves and nerve bundles by providing better contrast between the nerves and the surrounding tissues. The purpose of the study was to validate diffusion-weighted MR (DW-MR) neurography in visualizing the lumbar plexus during preoperative planning of lateral transpsoas surgery. Ninety-four (188 lumbar plexuses) spine patients underwent a DW-MR examination of the lumbar plexus in relation to the L3-4 and L4-5 disc spaces and superior third of the L5 vertebral body. Images were reconstructed in the axial plane using high-resolution Maximum Intensity projection (MIP) overlay templates at the disc space and L3-4 and L4-5 interspaces. 10 and 22 mm MIP templates were chosen to mimic the working zone of standard lateral access retractors. The positions of the L4 nerve root and femoral nerve were analyzed relative to the L4-5 disc in axial and sagittal planes. Third-party radiologists and a senior spine surgeon performed the evaluations, with inter- and intraobserver testing performed. In all subjects, the plexus was successfully mapped. At L3-4, in all but one case, the components of the plexus (except the genitofemoral nerve) were located in the most posterior quadrant (zone IV). The L3 and L4 roots coalesced into the femoral nerve below the L4-5 disc space in all subjects. Side-to-side variation was noted, with the plexus occurring in zone IV in 86.2 % right and only 78.7 % of left sides. At the superior third of L5, the plexus was found in zone III in 27.7 % of right and 36.2 % of left sides; and in zone II in 4.3 % right and 2.1 % left sides. Significant inter- and intraobserver agreement was found. By providing the surgeon with a preoperative roadmap of the lumbar plexus, DW-MR may improve the safety profile of lateral access procedures.

US$19.90

PMID: 25266892

DOI: 10.1007/s00586-014-3598-y


Other references

Li, L.; Wu, S.; Li, P.; Zhuo, L.; Gao, Y.; Xu, Y., 2016: Hypoxic Preconditioning Combined with Microbubble-Mediated Ultrasound Effect on MSCs Promote SDF-1/CXCR4 Expression and its Migration Ability: An In Vitro Study. Our objective is to investigate the promoting effect of hypoxic preconditioning combined with microbubble (MB)-mediated ultrasound (US) on the SDF-1/CXCR4 expression and the migration ability of mesenchymal stem cells (MSCs). Based on the uniform...

Tarazov, P.G., 1995: Hepatic chemoembolization: are prophylactic antibiotics necessary?. Journal of Vascular and Interventional Radiology 6(4): 658-659

Attorri, S.; Salomon, S.; Carena, J., 1998: Rhabdomyolysis associated to disseminated gonococcal infection in an elderly woman. Disseminated Gonococcal Infection (DGI) is very unusual in elderly patients and its association with Rhabdomyolysis (RML) has not been published for which reason we are presenting a case of RML secondary to DGI in an elderly women. We presume that...

Stringham, J.C.; Love, R.B.; Welter, D.; Canver, C.C.; Mentzer, R.M.Jr, 1997: Does preservation with University of Wisconsin solution improve heart transplant efficiency?. Circulation 96(8 SUPPL ): I369, 10/21/97

Querner, E.P.; Tallaksen, L.M.; Kasparek, L.; Lanen, H.A.J. van, 1997: Impact of land-use, climate change and ground-water abstraction on streamflow droughts using physically-based models. Changes in land-use, climate and groundwater abstractions have an impact on river flows and so the effect of these changes on streamflow droughts are analysed using the models BILAN, HBVMOR, MODFLOW and MOGROW. These models are physically-based an...

Mita, M.M.; Gong, J.; Chawla, S.P., 2014: Ridaforolimus in advanced or metastatic soft tissue and bone sarcomas. Patient outcomes remain poor for advanced or metastatic soft tissue sarcomas (STS) and bone sarcomas despite a growing number of clinical trials involving single- and multi-agent chemotherapy. mTOR is an intracellular kinase that plays a central r...

Grolier, P.; Elcombe, C.R., 1993: In vitro inhibition of carnitine acyltransferase activity in mitochondria from rat and mouse liver by a diethylhexylphthalate metabolite. The effects of mono(2-ethyl-5-oxohexyl)phthalate (ME(O)HP), a di(2-ethylhexyl)phthalate (DEHP) metabolite and a potent peroxisomal inducer, on the mitochondrial beta-oxidation were investigated. In isolated rat hepatocytes, ME(O)HP inhibited long...

Ford, Julian, 1963: Dispersal and mortality in the pied cormorant in Western Australia. An analysis of 30 banding recoveries of pied cormorants (Phalacrocorax varius) ringed as nestlings in Western Australia revealed that in their 1st year of life cormorants disperse randomly along coastlines and up estuaries for distances up to 200...

Tesfa, L.; Volk, H-Dieter.; Kern, F., 2003: Comparison of proliferation and rapid cytokine induction assays for flow cytometric T-cell epitope mapping. Background: T-cell epitope mapping by flow cytometry based on rapid ex vivo peptide-specific cytokine induction in T cells is very efficient and time saving compared with traditional assays. We investigated whether the same epitopes could be ident...

Green, D.M.; Hall, B., 1988: Pregnancy outcome following treatment during childhood or adolescence for Hodgkin's disease. To evaluate the outcome of pregnancies occurring after the completion of treatment for Hodgkin's disease in children or adolescents, questionnaries were sent to 93 former patients diagnosed after January 1, 1960, who were currently 18 or more...