Advertisement

Traumatic Lesions of the Lumbosacral Plexus: Microsurgical Treatment

  • A. Alexandre
  • G. Stevanato
  • F. Di Toma
  • F. Di Paola
  • F. Spigariol
  • A. Carteri
Conference paper
Part of the Advances in Neurosurgery book series (NEURO, volume 21)

Abstract

In severely injured patients there is sometimes complete palsy of an inferior limb. This may be the expression of a lesion of the innervation of the limb at various anatomical levels; the cauda, nerve roots inside the foramina, different elements of the lumbosacral plexus, or the terminal branches may be involved. Traumatic lesions of the lumbosacral plexus are rarely reported in the literature. This is because (a) these are rare lesions, intraspinal aside from lesions of the cauda and of nerve roots and lesions of terminal branches, (b) the correct diagnosis is difficult since these anatomical structures are deep seated and not easily studied, even by modem diagnostic tools, and (c) the surgical approach is difficult since the microsurgical field is very deep, and the nerves are covered by large vessels and muscles very adherent to the spine. Diagnosis is difficult because the lesions are often multiple and are located in different anatomical sites: intra or extraspinal, pre-, intra-, or postplexal. The problem is complicated by the frequent association with severe bony lesions in the spine, lumbosacral junction, or coxofemoral articulation. The entailed problems of stability and their treatment may delay diagnosis and treatment of neural damage.

Keywords

Brachial Plexus Terminal Branch Brachial Plexus Injury Traumatic Lesion Biceps Femoris Muscle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Alexandre A, Caretri A (1988) Il trattamento chirurgico delle lesioni traumatiche del plesso lombare. 37th congress of the Italian Neurosurgical Society, Treviso, 15–18 JuneGoogle Scholar
  2. 2.
    Brunelli G, Vigasio A (1986) Lumbar and sacral plexus surgery. Periph Nerve Repair Regen 4:21–25Google Scholar
  3. 3.
    Meyers MA (1976) Dynamic radiology of the abdomen: normal and pathologic anatomy. Springer, Berlin Heidelberg New YorkGoogle Scholar
  4. 4.
    Millesi H (1981) Internal neurolysis. In: Gorio A, Millesi H, Mingrino S (eds) Posttraumatic peripheral nerve regeneration. Raven, New York, pp 197–208Google Scholar
  5. 5.
    Narakas A (1986) Discussion and conclusions of the round table on sciatic nerve lesions of the G.A.M. Periph Nerve Repair Regen 4:75–76Google Scholar
  6. 6.
    Shapiro R (1977) Myelography. Year Book Medical Publishers, ChicagoGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • A. Alexandre
    • 1
  • G. Stevanato
    • 1
  • F. Di Toma
    • 2
  • F. Di Paola
    • 2
  • F. Spigariol
    • 3
  • A. Carteri
    • 1
  1. 1.Division of NeurosurgeryPadova University, Treviso City HospitalTrevisoItaly
  2. 2.Department of Radiology IIITreviso City HospitalTrevisoItaly
  3. 3.Department of RadiologyMontebelluna HospitalMontebellunaItaly

Personalised recommendations