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James C. Anderson - One of the best experts on this subject based on the ideXlab platform.
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Acute Improvement in Intraoperative EMG During Common Fibular Nerve Decompression in Patients with Symptomatic Diabetic Sensorimotor Peripheral Neuropathy: EMG and Clinical Attribute Interrelations.
Journal of neurological surgery. Part A Central European neurosurgery, 2020Co-Authors: Dwayne S Yamasaki, D Scott Nickerson, James C. AndersonAbstract:STUDY AIMS Electromyographic (EMG) recordings of the Fibularis longus and tibialis anterior muscles were performed intraoperatively during Nerve decompression (ND) of the Common Fibular Nerve (CFN) in patients with symptomatic diabetic sensorimotor peripheral neuropathy. Patient demographics and clinical attributes were compared against changes in EMG after ND and analyzed for possible correlations. METHODS Intraoperative changes in CFN EMG were analyzed for correlations against sex, age, body mass index (BMI), hemoglobin A1c (A1c), and type and duration of diabetes. RESULTS Statistically significant changes were found between EMG changes and patient attributes, but no individual correlations were established. Significant EMG improvement was observed for both men and women (p 39.9: p = 0.043), and highest A1c levels (> 6.4%; p
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acute improvement in intraoperative emg during Common Fibular Nerve decompression in patients with symptomatic diabetic sensorimotor peripheral neuropathy emg and clinical attribute interrelations
Central European Neurosurgery, 2020Co-Authors: Dwayne S Yamasaki, Scott D Nickerson, James C. AndersonAbstract:Study Aims Electromyographic (EMG) recordings of the Fibularis longus and tibialis anterior muscles were performed intraoperatively during Nerve decompression (ND) of the Common Fibular Nerve (CFN) in patients with symptomatic diabetic sensorimotor peripheral neuropathy. Patient demographics and clinical attributes were compared against changes in EMG after ND and analyzed for possible correlations. Methods Intraoperative changes in CFN EMG were analyzed for correlations against sex, age, body mass index (BMI), hemoglobin A1c (A1c), and type and duration of diabetes. Results Statistically significant changes were found between EMG changes and patient attributes, but no individual correlations were established. Significant EMG improvement was observed for both men and women (p 39.9: p = 0.043), and highest A1c levels (> 6.4%; p Conclusion Although long-term clinical studies are needed, these results provide insight into which patients might benefit most from this surgery. These results also suggest that surgical ND can produce an acute improvement in Nerve function for both men and women, for people with type 1 and 2 diabetes, and across a wide range of ages, BMI, A1c levels, and disease duration.
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Acute Improvement in Intraoperative EMG Following Common Fibular Nerve Decompression in Patients with Symptomatic Diabetic Sensorimotor Peripheral Neuropathy: 1. EMG Results.
Journal of neurological surgery. Part A Central European neurosurgery, 2016Co-Authors: James C. Anderson, D Scott Nickerson, Brian L Tracy, Roger J Paxton, Dwayne S YamasakiAbstract:Background and Study Aims Electromyographic (EMG) recordings of the Fibularis longus (FL) and tibialis anterior (TA) muscles were performed intraoperatively during Common Fibular Nerve (CFN) Nerve decompression (ND) in patients with symptomatic diabetic sensorimotor peripheral neuropathy (DSPN) and clinical Nerve compression. Materials and Methods Forty-six legs in 40 patients underwent surgical ND by external neurolysis; FL and TA muscles were monitored intraoperatively. Evoked EMGs were recorded just prior to and within 1 minute after ND. Results Thirty-eight legs (82.6%) demonstrated EMG improvement 1 minute after ND. Sixty muscles (31 FL, 29 TA) were monitored, with 44 (73.3%) improving in EMG amplitude. Mean change in EMG amplitude represented a 73.6% improvement (p
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Acute Improvement in Intraoperative EMG Following Common Fibular Nerve Decompression in Patients with Symptomatic Diabetic Sensorimotor Peripheral Neuropathy: 1. EMG Results.
Central European Neurosurgery, 2016Co-Authors: James C. Anderson, Brian L Tracy, Roger J Paxton, D. Nickerson, Dwayne S YamasakiAbstract:Background and Study Aims Electromyographic (EMG) recordings of the Fibularis longus (FL) and tibialis anterior (TA) muscles were performed intraoperatively during Common Fibular Nerve (CFN) Nerve decompression (ND) in patients with symptomatic diabetic sensorimotor peripheral neuropathy (DSPN) and clinical Nerve compression. Materials and Methods Forty-six legs in 40 patients underwent surgical ND by external neurolysis; FL and TA muscles were monitored intraoperatively. Evoked EMGs were recorded just prior to and within 1 minute after ND. Results Thirty-eight legs (82.6%) demonstrated EMG improvement 1 minute after ND. Sixty muscles (31 FL, 29 TA) were monitored, with 44 (73.3%) improving in EMG amplitude. Mean change in EMG amplitude represented a 73.6% improvement (p Conclusion This is the first report of acute changes in objective EMG responses during ND of CFN in DSPN patients and demonstrates that patients with symptomatic DSPN and clinical Nerve entrapment have latent but functional axons that surgical ND can improve immediately.
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Common Fibular Nerve Compression: Anatomy, Symptoms, Clinical Evaluation, and Surgical Decompression
Clinics in podiatric medicine and surgery, 2016Co-Authors: James C. AndersonAbstract:This article thoroughly describes the clinical examination and treatment of Common Fibular (peroneal) Nerve compression. Aspects discussed include the anatomy of the Nerve, cause of entrapment, symptoms associated with impairment, and a surgical approach to decompress the entrapped Nerve. The standard protocol for decompression as it would apply to the Common Fibular Nerve tunnel is illustrated.
Dong Hwee Kim - One of the best experts on this subject based on the ideXlab platform.
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Sonographic evaluation of the optimal needle insertion site in the biceps femoris short head.
American journal of physical medicine & rehabilitation, 2020Co-Authors: Seyoung Shin, Ki Hoon Kim, Dong Hwee KimAbstract:OBJECTIVE To identify the optimal needle placement for electromyographic examination of the biceps femoris short head (BFS) muscle in relation to the biceps femoris long head (BFL) tendon through sonographic evaluation. DESIGN This cross-sectional observational study involved 36 lower limbs of 18 healthy volunteers. The distances and angles indicating the relationships between the Common Fibular Nerve (CFN) and the medial or lateral border of the BFL tendon were measured at 5 and 7 cm proximal to the tip of the Fibular head (P1 and P2, respectively) using ultrasonography. RESULTS The median values of the distance between the BFL tendon and the CFN were significantly longer in the lateral approach than in the medial approach at the P1 and P2 levels. The median values of the angles between the vertical line to the BFL tendon and the CFN were significantly larger in the lateral approach than in the medial approach at both levels. CONCLUSIONS The CFN is located just below the medial border of the BFL tendon at a near-vertical degree from the skin. It is strongly recommended that the needle should be inserted on the lateral side of the BFL tendon during needle electromyographic examination of the BFS muscle.
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Branching Patterns and Anatomical Course of the Common Fibular Nerve.
Annals of rehabilitation medicine, 2019Co-Authors: G. Y. Kim, Chae Hyeon Ryou, Ki Hoon Kim, Dasom Kim, Im Joo Rhyu, Dong Hwee KimAbstract:OBJECTIVE To present the branching patterns and anatomical course of the Common Fibular Nerve (CFN) and its relationship with Fibular head (FH). METHODS A total of 21 limbs from 12 fresh cadavers were dissected. The FH width (FH_width), distance between the FH and CFN (FH_CFN), and thickness of the Nerve were measured. The ratio of the FH_CFN to FH_width was calculated as follows:
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branching patterns and anatomical course of the Common Fibular Nerve
Annals of Rehabilitation Medicine, 2019Co-Authors: G. Y. Kim, Chae Hyeon Ryou, Ki Hoon Kim, Dasom Kim, Im Joo Rhyu, Dong Hwee KimAbstract:OBJECTIVE To present the branching patterns and anatomical course of the Common Fibular Nerve (CFN) and its relationship with Fibular head (FH). METHODS A total of 21 limbs from 12 fresh cadavers were dissected. The FH width (FH_width), distance between the FH and CFN (FH_CFN), and thickness of the Nerve were measured. The ratio of the FH_CFN to FH_width was calculated as follows: <1, cross type and ≥1, posterior type. Angle between the CFN and vertical line of the lower limb 5 cm proximal to the tip of the FH was measured. Branching patterns of the lateral cutaneous Nerve of the calf (LCNC) were classified into four types according to its origin and direction as follows: type 1a, lateral margin of the CFN; type 1b, medial margin of the CFN; type 2, lateral sural cutaneous Nerve (LSCN); and type 3, CFN and LSCN. RESULTS In the cross type (15 cases, 71.4%), the ratio of FH_CFN/FH_width was 0.83 and the angle was 13.0°. In the posterior type (6 cases, 28.6%), the ratio was 1.04 and the angle was 11.0°. In the branching patterns of LCNC, type 2 was the most Common (10 cases), followed by types 1a and 1b (both, 5 cases). CONCLUSION Location of the CFN around the FH might be related to the development of its neuropathy, especially in the cross type of CFN. The LCNC showed various branching patterns and direction, which could be associated with difficulties of electrophysiologic testing.
Marcus André Acioly - One of the best experts on this subject based on the ideXlab platform.
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Fibular Nerve repair by lateral sural cutaneous Nerve graft: anatomical feasibility study and clinical results.
World neurosurgery, 2020Co-Authors: Larissa Thiene Watabe, Pablo Valença Borges Dos Santos, Fabio A. Mendes, Carlos Roberto De Lima, Marcus André AciolyAbstract:Abstract Object The Common Fibular Nerve (CFN) is the most frequently injured Nerve in the lower limbs. Surgical management is necessary in approximately two-thirds of patients and includes neurolysis, suture, graft repair or Nerve transfer. The distal sural Nerve is the preferred donor for grafting, but it is not without complications and requires a second incision. We sought to study the surgical anatomy of the lateral sural cutaneous Nerve (LSCN) with the aim of repairing CFN injuries through the same incision and as a potential source for grafting in other Nerve injuries. Methods The popliteal fossa was dissected in 11 lower limbs of embalmed cadavers to study LSCN variations. Four patients with CFN injuries then underwent surgical repair by LSCN grafting using the same surgical approach. Results At the medial margin of the biceps femoris, the LSCN emerged from the CFN approximately 8.15 cm above the Fibular head. The LSCN ran longitudinally to the long axis of the popliteal fossa, with an average of 3.2 cm medial to the Fibular head. The mean LSCN length and diameter were 9.61 cm and 3.6 mm, respectively. The LSCN could be harvested in all patients for grafting. The mean graft length was 4.4 cm. Motor function was consistently recovered for foot eversion but was recovered to a lesser extent for dorsiflexion and toe extension. All patients recovered sensitive function (75% of S3). Hypoesthesia was recognized at the calf. Conclusions LSCN harvest is a viable alternative for Nerve grafting, especially for repairing short CFN injuries, thereby avoiding the need for a second incision.
Dwayne S Yamasaki - One of the best experts on this subject based on the ideXlab platform.
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Acute Improvement in Intraoperative EMG During Common Fibular Nerve Decompression in Patients with Symptomatic Diabetic Sensorimotor Peripheral Neuropathy: EMG and Clinical Attribute Interrelations.
Journal of neurological surgery. Part A Central European neurosurgery, 2020Co-Authors: Dwayne S Yamasaki, D Scott Nickerson, James C. AndersonAbstract:STUDY AIMS Electromyographic (EMG) recordings of the Fibularis longus and tibialis anterior muscles were performed intraoperatively during Nerve decompression (ND) of the Common Fibular Nerve (CFN) in patients with symptomatic diabetic sensorimotor peripheral neuropathy. Patient demographics and clinical attributes were compared against changes in EMG after ND and analyzed for possible correlations. METHODS Intraoperative changes in CFN EMG were analyzed for correlations against sex, age, body mass index (BMI), hemoglobin A1c (A1c), and type and duration of diabetes. RESULTS Statistically significant changes were found between EMG changes and patient attributes, but no individual correlations were established. Significant EMG improvement was observed for both men and women (p 39.9: p = 0.043), and highest A1c levels (> 6.4%; p
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acute improvement in intraoperative emg during Common Fibular Nerve decompression in patients with symptomatic diabetic sensorimotor peripheral neuropathy emg and clinical attribute interrelations
Central European Neurosurgery, 2020Co-Authors: Dwayne S Yamasaki, Scott D Nickerson, James C. AndersonAbstract:Study Aims Electromyographic (EMG) recordings of the Fibularis longus and tibialis anterior muscles were performed intraoperatively during Nerve decompression (ND) of the Common Fibular Nerve (CFN) in patients with symptomatic diabetic sensorimotor peripheral neuropathy. Patient demographics and clinical attributes were compared against changes in EMG after ND and analyzed for possible correlations. Methods Intraoperative changes in CFN EMG were analyzed for correlations against sex, age, body mass index (BMI), hemoglobin A1c (A1c), and type and duration of diabetes. Results Statistically significant changes were found between EMG changes and patient attributes, but no individual correlations were established. Significant EMG improvement was observed for both men and women (p 39.9: p = 0.043), and highest A1c levels (> 6.4%; p Conclusion Although long-term clinical studies are needed, these results provide insight into which patients might benefit most from this surgery. These results also suggest that surgical ND can produce an acute improvement in Nerve function for both men and women, for people with type 1 and 2 diabetes, and across a wide range of ages, BMI, A1c levels, and disease duration.
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Acute Improvement in Intraoperative EMG Following Common Fibular Nerve Decompression in Patients with Symptomatic Diabetic Sensorimotor Peripheral Neuropathy: 1. EMG Results.
Journal of neurological surgery. Part A Central European neurosurgery, 2016Co-Authors: James C. Anderson, D Scott Nickerson, Brian L Tracy, Roger J Paxton, Dwayne S YamasakiAbstract:Background and Study Aims Electromyographic (EMG) recordings of the Fibularis longus (FL) and tibialis anterior (TA) muscles were performed intraoperatively during Common Fibular Nerve (CFN) Nerve decompression (ND) in patients with symptomatic diabetic sensorimotor peripheral neuropathy (DSPN) and clinical Nerve compression. Materials and Methods Forty-six legs in 40 patients underwent surgical ND by external neurolysis; FL and TA muscles were monitored intraoperatively. Evoked EMGs were recorded just prior to and within 1 minute after ND. Results Thirty-eight legs (82.6%) demonstrated EMG improvement 1 minute after ND. Sixty muscles (31 FL, 29 TA) were monitored, with 44 (73.3%) improving in EMG amplitude. Mean change in EMG amplitude represented a 73.6% improvement (p
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Acute Improvement in Intraoperative EMG Following Common Fibular Nerve Decompression in Patients with Symptomatic Diabetic Sensorimotor Peripheral Neuropathy: 1. EMG Results.
Central European Neurosurgery, 2016Co-Authors: James C. Anderson, Brian L Tracy, Roger J Paxton, D. Nickerson, Dwayne S YamasakiAbstract:Background and Study Aims Electromyographic (EMG) recordings of the Fibularis longus (FL) and tibialis anterior (TA) muscles were performed intraoperatively during Common Fibular Nerve (CFN) Nerve decompression (ND) in patients with symptomatic diabetic sensorimotor peripheral neuropathy (DSPN) and clinical Nerve compression. Materials and Methods Forty-six legs in 40 patients underwent surgical ND by external neurolysis; FL and TA muscles were monitored intraoperatively. Evoked EMGs were recorded just prior to and within 1 minute after ND. Results Thirty-eight legs (82.6%) demonstrated EMG improvement 1 minute after ND. Sixty muscles (31 FL, 29 TA) were monitored, with 44 (73.3%) improving in EMG amplitude. Mean change in EMG amplitude represented a 73.6% improvement (p Conclusion This is the first report of acute changes in objective EMG responses during ND of CFN in DSPN patients and demonstrates that patients with symptomatic DSPN and clinical Nerve entrapment have latent but functional axons that surgical ND can improve immediately.
Luca Padua - One of the best experts on this subject based on the ideXlab platform.
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Fibular Nerve damage in knee dislocation: Spectrum of ultrasound patterns
Muscle & nerve, 2015Co-Authors: Daniele Coraci, H. Tsukamoto, Giuseppe Granata, Chiara Briani, Valter Santilli, Luca PaduaAbstract:Introduction At least 25% of knee dislocations are associated with Common Fibular Nerve injury. Diagnosis is usually based on clinical and neurophysiological findings. We assessed the role of Nerve ultrasound in Common Fibular Nerve injury. Methods Eight consecutive patients (6 men and 2 women, mean age 34 years) with knee luxation referred to our laboratory underwent clinical, neurophysiological, and ultrasound examination. Results In all patients we observed a similar pattern: severe weakness (plegia or severe paresis); neurophysiological involvement of both Fibular Nerve branches; and ultrasound evidence of increased Fibular Nerve area with hypoechogenicity. On follow-up evaluation, 6 patients remained stable, and 2 patients improved. The greater the ultrasound Fibular Nerve enlargement, the worse the recovery. Conclusions Nerve ultrasound was confirmed to be a useful diagnostic/prognostic tool in traumatic Nerve lesions. A prompt ultrasound examination of the Fibular Nerve should be considered after any case of knee dislocation. Muscle Nerve 51: 859–863, 2015
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Ultrasound and neurophysiological correlation in Common Fibular Nerve conduction block at Fibular head
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2014Co-Authors: H. Tsukamoto, Giuseppe Granata, Daniele Coraci, Ilaria Paolasso, Luca PaduaAbstract:Abstract Objective Ultrasound (US) and neurophysiological examination are useful tools in the evaluation of Common Fibular mononeuropathy. There is only a report comparing US and electrophysiological parameters in patients with Common Fibular Nerve (CFN) conduction block at Fibular head. We investigated the correlation between US and neurophysiologic findings in this condition. Methods We retrospectively reviewed patients with CFN assessed in our lab during last 2 years. Each patient underwent to clinical, neurophysiological and ultrasound evaluations. Cross sectional area (CSA) of CFN at Fibular head was assessed. Results Twenty-four patients were included. Motor Nerve conduction study showed a reduction of distal compound muscle action potential (CMAP) amplitude in 10 patients (mean 1.3 mV). US showed an increased CSA in 10 patients. Statistical analysis revealed a strong correlation between the increased CSA and the CMAP reduction of CFN. Conclusion Our data suggest that usually US examination is normal in CFN conduction block at Fibular head. However the association with axonal damage is frequently accompanied by an increase of CSA. Significance Ultrasound evaluation may represent a powerful diagnostic/prognostic tool in cases with CPN conduction block at Fibular head because it usually shows normal pattern in pure conduction block and increase of CSA in associated axonal damage.