Traumatic and Postoperative Lesions of the Lumbosacral Plexus

Stoehr, M

doi:10.1001/archneur.1978.00500350061013

Cited by 49 publications

(14 citation statements)

References 9 publications

(1 reference statement)

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“…On the other hand, sciatic and both gluteal nerves are adjacent to this joint. Despite a number of publications reporting lumbosacral plexopathy in patients with acetabular fractures, 15 and our own finding of a 0.38% incidence of lumbosacral plexopathy among these patients, the most prudent practical explanation is damage to the multiple individual nerves rather than the plexus. The issue of lumbosacral plexopathy in fractures distal to the pelvic rim is further obscured by the reports of plexopathy among patients with femoral fractures or after total hip replacement.…”

Section: Discussioncontrasting

confidence: 55%

“…Stoehr reported that 10 of 53 cases of lumbosacral plexopathy were due to femoral fractures and 17 to total hip replacement. 15 In our series, there were 2 patients with midshaft femoral fracture and EMG findings suggestive of lumbosacral plexopathy. Because of inconsistency of the injury with the neurologic deficit, magnetic resonance imaging of the pelvis and thigh was performed in 1 case and confirmed the clinical suspicion of multiple proximal peripheral nerve injuries rather than a lumbosacral plexopathy.…”

Section: Discussionmentioning

confidence: 65%

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Lumbosacral plexopathy in pelvic trauma

2000

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 65%

Lumbosacral plexopathy in pelvic trauma

2000

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“…This explains the paucity of published series on this subject 1,2 . Perforating objects, gunshot wounds, pelvic bone and hip fractures, retroperitoneal hemorrhage, iatrogenic lesions after abdominal and pelvic surgeries are the most common etiological factors mentioned in the literature [2][3][4][5][6][7] . Surgery as treatment of lumbar plexus lesions is uncommon 2,8,9 and, because of its wide distribution, the complete exposure of the lumbar plexus by a single approach is practically impossible.…”

Section: Discussionmentioning

confidence: 99%

Critical analysis of extra peritoneal antero-lateral approach for lumbar plexus

Martins

Mônaco²,

Siqueira

et al. 2011

Arq. Neuro-Psiquiatr.

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Lesions of lumbar plexus are uncommon and descriptions of surgical access are derived from vertebral spine approaches. Method: The extraperitoneal anterolateral approach to the lumbar plexus was performed in six adult fresh cadavers. The difficulties on dissection were related. Results: An exposure of all distal elements of lumbar plexus was possible, but a cranial extension of the incision was needed to reach the iliohypogastric nerve in all cases. Ligation of vessels derived from common iliac artery was necessary for genitofemoral and obturator nerves exposure in two cases. The most proximal part of the lumbar roots could be identified only after dissection and clipping of most lumbar vessels. Conclusion: The extraperitoneal anterolateral approach allows appropriate exposure of terminal nerves of lumbar plexus laterallly to psoas major muscle. Cranial extension of the cutaneous incision may be necessary for exposure of iliohypogastric nerve. Roots exposure increases the risk of vascular damage. Key words: lumbar plexus, surgical approach, peripheral nerve.Análise crítica do acesso anterolateral retroperitoneal ao plexo lombar RESUMO As lesões do plexo lombar são incomuns e as descrições dos acessos cirúrgicos são derivadas de vias de acesso à coluna vertebral. Método: A via extraperitoneal anterolateral foi realizada em seis cadáveres para o acesso ao plexo lombar. Eventuais dificuldades na dissecção foram relatadas. Resultados: Tal acesso permitiu a exposição dos elementos distais do plexo lombar, mas uma extensão cranial da incisão foi necessária para a exposição do nervo iliohipogástrico. Para a exposição dos nervos genitofemoral e obturador houve a necessidade da ligadura de vasos originados da artéria ilíaca comum em 2 casos. As raízes foram identificadas somente após dissecção e ligadura dos vasos lombares. Conclusão: O acesso anterolateral extraperitoneal permite uma exposição adequada dos nervos terminais do plexo lombar lateralmente ao músculo psoas maior. Uma extensão cranial da incisão pode ser necessária para exposição do nervo iliohipogástrico. A exposição das raízes implica em maior risco de lesão vascular. Palavras-chave: plexo lombar, acesso cirúrgico, nervo periférico.

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“…As the functional outcome after surgical treatment of lumbosacral nerve defects and lumbosacral plexus avulsion remains poor, conservative treatment has been advocated [21]. The peripheral nerve injury model in our study is similar to human lumbosacral nerve in terms of anatomy and function.…”

Section: Discussionmentioning

confidence: 64%