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相关概念视频

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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Spinal Nerves: Anatomy01:23

Spinal Nerves: Anatomy

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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.
There are 31 bilateral pairs of spinal nerves, each emerging from the spinal cord through the intervertebral foramina—openings between adjacent vertebrae. These nerves are...
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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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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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相关实验视频

Updated: Jun 28, 2025

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
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6. 6. 6. 这是一个很大的问题. 持续性脊柱疼痛综合征2型

Johan van de Minkelis1,2, Laurens Peene3, Steven P Cohen4,5

  • 1Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.

Pain practice : the official journal of World Institute of Pain
|April 15, 2024
PubMed
概括

持续脊柱疼痛综合征2型 (PSPS-2) 诊断依赖于患者病史,检查和成像. 当保守方法失败时,干预性治疗,如脉冲射频,粘合溶解和脊髓刺激,显示出有希望的结果.

关键词:
背部疼痛 疼痛 背部疼痛基于证据的医学医学.

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科学领域:

  • 神经外科 神经外科
  • 疼痛管理 疼痛管理
  • 脊柱外科手术 脊柱外科手术

背景情况:

  • 持续性脊柱疼痛综合征2型 (PSPS-2),以前称为失败的背部手术综合征,涉及脊柱手术后的慢性疼痛.
  • 病因学包括程序错误,技术故障,生物力学变化和并发症.
  • 诊断包括患者病史,体检和医学成像.

研究的目的:

  • 审查和总结有关PSPS-2诊断和治疗的当前文献.
  • 评估针对PSPS-2的各种治疗干预措施的证据.

主要方法:

  • 关于PSPS-2诊断和治疗的综合文献搜索.
  • 综合和总结检索的研究.

主要成果:

  • 保守治疗 (运动,治疗) 对PSPS-2疗效的证据质量不佳.
  • 药理治疗证据非常有限.
  • 干预方案,如脉冲射频 (PRF),外周粘合溶解和脊柱内镜显示潜在的好处.
  • 脊髓刺激 (SCS) 对于神经病关节疼痛和在选定的PSPS-2患者中潜在的轴痛是有效的.

结论:

  • 通过临床评估和成像来确立PSPS-2诊断.
  • 保守干预缺乏强有力的证据.
  • PRF,粘合溶解和SCS提供了更高的证据水平和安全性,在保守治疗失败后需要考虑.