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Masaaki Nagata – One of the best experts on this subject based on the ideXlab platform.

  • Herpes zoster-induced trunk muscle paresis presenting with Abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report.
    Archives of Physical Medicine and Rehabilitation, 2010
    Co-Authors: Syoichi Tashiro, Kazuto Akaboshi, Yukiko Kobayashi, Toshiki Mori, Masaaki Nagata, Meigen Liu

    Abstract:

    Herpes zoster (HZ)-induced Abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with Abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right Abdominal Bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft thoracolumbosacral orthosis for pain relief and trunk stability, muscle reeducation of the paretic Abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis.

  • herpes zoster induced trunk muscle paresis presenting with Abdominal wall pseudohernia scoliosis and gait disturbance and its rehabilitation a case report
    Archives of Physical Medicine and Rehabilitation, 2010
    Co-Authors: Syoichi Tashiro, Kazuto Akaboshi, Yukiko Kobayashi, Toshiki Mori, Masaaki Nagata

    Abstract:

    Abstract Tashiro S, Akaboshi K, Kobayashi Y, Mori T, Nagata M, Liu M. Herpes zoster–induced trunk muscle paresis presenting with Abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report. Herpes zoster (HZ)-induced Abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with Abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right Abdominal Bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft thoracolumbosacral orthosis for pain relief and trunk stability, muscle reeducation of the paretic Abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis.

Charles E Butler – One of the best experts on this subject based on the ideXlab platform.

  • minimally invasive component separation results in fewer wound healing complications than open component separation for large ventral hernia repairs
    Journal of The American College of Surgeons, 2012
    Co-Authors: Shadi Ghali, Donald P Baumann, Kristin C Turza, Charles E Butler

    Abstract:

    Background Minimally invasive component separation (CS) with inlay bioprosthetic mesh (MICSIB) is a recently developed technique for Abdominal wall reconstruction that preserves the rectus abdominis perforators and minimizes subcutaneous dead space using limited-access tunneled incisions. We hypothesized that MICSIB would result in better surgical outcomes than conventional open CS. Study Design All consecutive patients who underwent CS (open or minimally invasive) with inlay bioprosthetic mesh for ventral hernia repair from 2005 to 2010 were included in a retrospective analysis of prospectively collected data. Surgical outcomes, including wound-healing complications, hernia recurrences, and Abdominal Bulge/laxity rates, were compared between patient groups based on the type of CS repair, either MICSIB or open. Results Fifty-seven patients who underwent MICSIB and 50 who underwent open CS were included. Mean follow-ups were 15.2 ± 7.7 months and 20.7 ± 14.3 months, respectively. Mean fascial defect size was significantly larger in the MICSIB group (405.4 ± 193.6 cm 2 vs 273.8 ± 186.8 cm 2 ; p=0.002). The incidences of skin dehiscence (11% vs 28%; p=0.011), all wound-healing complications (14% vs 32%; p=0.026), Abdominal wall laxity/Bulge (4% vs 14%; p=0.056), and hernia recurrence (4% vs 8%; p=0.3) were lower in the MICSIB group than in the open CS group. Conclusions MICSIB resulted in fewer wound-healing complications than did open CS used for complex Abdominal wall reconstructions. These findings are likely attributable to the preservation of paramedian skin vascularity and reduction in subcutaneous dead space with MICSIB. MICSIB should be considered for complex Abdominal wall reconstructions, particularly in patients at increased risk of wound-healing complications.

  • violation of the rectus complex is not a contraindication to component separation for Abdominal wall reconstruction
    Journal of The American College of Surgeons, 2012
    Co-Authors: Patrick B Garvey, Chad M Bailey, Donald P Baumann, Jun Liu, Charles E Butler

    Abstract:

    Background Component separation (CS) is an effective technique for reconstructing complex Abdominal wall defects. Violation of the rectus abdominis complex is considered a contraindication for CS, but we hypothesized that patients have similar outcomes with or without rectus complex violation. Study Design We retrospectively studied all consecutive patients who underwent CS for Abdominal wall reconstruction during 8 years and compared outcomes of patients with and without rectus violation. Primary outcomes measures included complications and hernia recurrence . Logistic regression analysis identified potential associations between patient, defect, and reconstructive characteristics and surgical outcomes. Results One hundred sixty-nine patients were included: 115 (68%) with and 54 (32%) without rectus violation. Mean follow-up was 21.3 ± 14.5 months. Patient and defect characteristics were similar, except for the rectus violation group having a higher body mass index. Overall complication rates were similar in the violation (24.3%) and nonviolation (24.0%) groups, as were the respective rates of recurrent hernia (7.8% vs 9.2%; p=0.79), Abdominal Bulge (3.5% vs 5.6%; p=0.71), skin dehiscence (20.0% vs 22.2%; p=0.74), skin necrosis (6.1% vs 3.7%; p=0.72), cellulitis (7.8% vs 9.2%; p=0.75), and abscess (12.3% vs 9.2%; p=0.58). Regression analysis demonstrated body mass index to be the only factor predictive of complications. Conclusions CS surgical outcomes were similar whether or not the rectus complex was violated. To our knowledge, this study is the first to evaluate the effects of rectus violation on surgical outcomes in CS patients. Surgeons should not routinely avoid CS when the rectus complex is violated.

  • Abdominal donor site outcomes for medial versus lateral deep inferior epigastric artery branch perforator harvest
    Plastic and Reconstructive Surgery, 2011
    Co-Authors: Patrick B Garvey, Seroos Salavati, Lei Feng, Charles E Butler

    Abstract:

    Background: Damage to the intercostal nerves during deep inferior epigastric perforator (DIEP) and muscle-sparing free transverse rectus abdominis musculocutaneous (TRAM) flap harvest compromises Abdominal wall integrity. Intercostal motor nerves are closely associated with the lateral branch of the deep inferior epigastric artery (DIEA); therefore, the authors hypothesized that medial branch flap donor sites would develop fewer Abdominal Bulges/hernias. Methods: The authors evaluated 2043 consecutive abdomen-based free flap breast reconstructions performed at The University of Texas M. D. Anderson Cancer Center between 2000 and 2010. Of these, the authors included only DIEP or muscle-sparing free TRAM flaps in which it could be clearly determined from which branch perforators were harvested. The authors examined the relationship between patient and treatment factors and donor-site hernia and Bulge. Results: The authors included 501 patients with a mean follow-up of 31 months [289 medial branch flaps (47 percent) and 326 lateral branch flaps (53 percent)]. Patient demographics, reconstruction timing, DIEP versus muscle-sparing free TRAM, unilateral versus bilateral distribution, and percentage of mesh closures were similar between the branch harvest groups. Twenty-eight donor sites (4.6 percent) developed a Bulge/hernia. Abdominal Bulge/hernia rates were similar between the medial and lateral branch donor sites (3.5 percent and 5.5 percent, respectively) (p = 0.20). Conclusions: This is the largest study to date comparing donor-site morbidity following medial or lateral DIEA branch harvest. Choice of perforators should be based on quality, size, and orientation. Medial versus lateral row perforators should not be harvested preferentially to reduce donor-site hernia or Bulge.

Syoichi Tashiro – One of the best experts on this subject based on the ideXlab platform.

  • Herpes zoster-induced trunk muscle paresis presenting with Abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report.
    Archives of Physical Medicine and Rehabilitation, 2010
    Co-Authors: Syoichi Tashiro, Kazuto Akaboshi, Yukiko Kobayashi, Toshiki Mori, Masaaki Nagata, Meigen Liu

    Abstract:

    Herpes zoster (HZ)-induced Abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with Abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right Abdominal Bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft thoracolumbosacral orthosis for pain relief and trunk stability, muscle reeducation of the paretic Abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis.

  • herpes zoster induced trunk muscle paresis presenting with Abdominal wall pseudohernia scoliosis and gait disturbance and its rehabilitation a case report
    Archives of Physical Medicine and Rehabilitation, 2010
    Co-Authors: Syoichi Tashiro, Kazuto Akaboshi, Yukiko Kobayashi, Toshiki Mori, Masaaki Nagata

    Abstract:

    Abstract Tashiro S, Akaboshi K, Kobayashi Y, Mori T, Nagata M, Liu M. Herpes zoster–induced trunk muscle paresis presenting with Abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report. Herpes zoster (HZ)-induced Abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with Abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right Abdominal Bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft thoracolumbosacral orthosis for pain relief and trunk stability, muscle reeducation of the paretic Abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis.