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Related Concept Videos

Spinal Nerves: Plexus II01:21

Spinal Nerves: Plexus II

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The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Spinal Nerves: Anatomy01:23

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Spinal nerves are pivotal conduits in the nervous system, bridging the central nervous system (CNS) with the peripheral nervous system (PNS). These nerves enable a complex communication network between the brain, spinal cord, and the rest of the body, facilitating sensory input, motor output, and autonomic functions.
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Spinal Nerves: Plexus I01:22

Spinal Nerves: Plexus I

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
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Related Experiment Video

Updated: Jul 10, 2025

Laminotomy for Lumbar Dorsal Root Ganglion Access and Injection in Swine
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1. Lumbosacral radicular pain.

Laurens Peene1, Steven P Cohen2, Jan Willem Kallewaard3,4

  • 1Department of Anesthesiology, Intensive Care, Emergency Medicine and Multidisciplinary Pain Center, Ziekenhuis Oost-Limburg, Genk/Lanaken, Belgium.

Pain Practice : the Official Journal of World Institute of Pain
|November 21, 2023
PubMed
Summary

Lumbosacral radicular pain diagnosis involves history, exam, and tests. Treatments vary by duration, with epidural steroids for subacute pain and pulsed radiofrequency for chronic cases.

Keywords:
epidural adhesiolysis/epiduroscopyepidural corticosteroidsevidence-based medicinelumbosacral radicular painpulsed radiofrequency treatmentspinal cord stimulation

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Area of Science:

  • Pain Medicine
  • Neurology
  • Spinal Disorders

Background:

  • Lumbosacral radicular pain affects multiple dermatomes, with significant prevalence in the general population.
  • Characterized by radiating pain below the knee, it impacts daily function.

Purpose of the Study:

  • To review and summarize the current literature on diagnosing and treating lumbosacral radicular pain.
  • To provide evidence-based recommendations for managing this condition.

Main Methods:

  • Comprehensive literature review on lumbosacral radicular pain diagnosis and treatment.
  • Synthesis of findings regarding diagnostic modalities and therapeutic interventions.

Main Results:

  • Diagnosis relies on patient history, clinical examination, and supplementary tests like imaging and nerve root blocks.
  • Transforaminal corticosteroid injections offer short-term relief for subacute pain.
  • Pulsed radiofrequency (PRF) near the dorsal root ganglion (DRG) provides longer relief for chronic pain.
  • Epidural adhesiolysis and spinal cord stimulation (SCS) are options for refractory cases.

Conclusions:

  • Diagnosis integrates clinical assessment with advanced investigations.
  • Epidural steroid injections are suitable for subacute lumbosacral radicular pain.
  • PRF is recommended for chronic lumbosacral radicular pain.
  • SCS and epidural adhesiolysis are reserved for refractory pain managed in specialized centers.