The Experts below are selected from a list of 45 Experts worldwide ranked by ideXlab platform
Shane R Tubbs - One of the best experts on this subject based on the ideXlab platform.
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anatomic study of Superior Cluneal Nerves revisiting the contribution of lumbar spinal Nerves
World Neurosurgery, 2019Co-Authors: Joe Iwanaga, Emily Simonds, Rod J Oskouian, Maia Schumacher, Shane R TubbsAbstract:Objective Superior Cluneal nerve (SCN) entrapment neuropathy can result in low back pain and thus be confused with other pathologies (e.g., lumbar disk disease). Therefore we performed cadaveric dissection of the SCN to better understand its anatomy and segmental origin. Methods Twenty sides from 10 Caucasian fresh frozen cadavers (6 females and 4 males) were used in this study. The diameter of the SCN, distance between the exit point of the SCN from the thoracolumbar fascia and midline, and distance between the exit point of the SCN from the thoracolumbar fascia and the posterior Superior iliac spine to the medial and lateral SCN were measured. The segmental origins of the SCNs were verified. Results Seventy-five percent of the dorsal rami of L1, 90% of L2, 95% of L3, 45% of L4, and 10% of L5 contributed to the SCN. The SCN was formed by 3 vertebral levels in 55% and by 4 vertebral levels in 30%. Three SCNs pierced the thoracolumbar fascia in 45%. Conclusions The origin of the SCN, which has been described in the textbook and literature for a long time, should be reconsidered on the basis of our study results.
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anatomic study of Superior Cluneal Nerves application to low back pain and surgical approaches to lumbar vertebrae
World Neurosurgery, 2018Co-Authors: Joe Iwanaga, Emily Simonds, Mayank Patel, Rod J Oskouian, Shane R TubbsAbstract:Objective The aim of this study was to investigate the anatomy of the Superior Cluneal Nerves more proximal to the posterior layer of the thoracolumbar fascia. Methods Twelve sides of 6 fresh-frozen cadavers were used. The age at death ranged from 54 to 88 years. After a transverse skin incision 10 mm above the iliac crest, the Superior Cluneal Nerves were detected by blunt dissection and traced back to the dorsal root ganglia. The diameter of the Nerves from L1 to L3 was measured. Also, the relationship to the erector spinae muscle and dorsal ramus was recorded. Results The mean diameters of the origin of the L1, L2, and L3 were 1.71 ± 0.29 mm, 1.73 ± 0.40 mm, and 1.52 ± 0.55 mm, respectively. On 7 sides (58.3%) for L1, seven sides (58.3%) for L2, and 10 sides (83.3%) for L3, the Nerves pierced the iliocostalis muscle. One side (8.3%) for L2 and one (8.3%) for L3 had no cutaneous branch. Conclusions The results of this study could help to elucidate the anatomy of the Superior Cluneal Nerves and help avoid complications during surgical approaches to the lumbar spine.
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anatomy and landmarks for the Superior and middle Cluneal Nerves application to posterior iliac crest harvest and entrapment syndromes
Journal of Neurosurgery, 2010Co-Authors: Shane R Tubbs, Matthew R Levin, Marios Loukas, Eric A Potts, Aaron A CohengadolAbstract:Object. To date, only scant descriptions of the Cluneal Nerves are available. As these Nerves, and especially the Superior group, may be encountered and injured during posterior iliac crest harvest for spinal arthrodesis procedures, the present study was performed to better elucidate their anatomy and to provide anatomical landmarks for their localization. Methods. The Superior and middle Cluneal Nerves were dissected from their origin to termination in 20 cadaveric sides. The distance between the posterior Superior iliac spine (PSIS) and Superior Cluneal Nerves at the iliac crest and the distance between this bony prominence and the origin of the middle Cluneals were measured. The specific course of each nerve was documented, and the diameter and length of all Cluneal Nerves were measured. Results. Superior and middle Cluneal Nerves were found on all sides. An intermediate Superior Cluneal nerve and lateral Superior Cluneal nerve were not identified on 4 and 5 sides, respectively. The Superior Cluneal Nerves always passed through the psoas major and paraspinal muscles and traveled posterior to the quadratus lumborum. The mean diameters of the Superior and middle Cluneal Nerves were 1.1 and 0.8 mm, respectively. From the PSIS, the Superior Cluneal branches passed at means of 5, 6.5, and 7.3 cm laterally on the iliac crest. At their origin, the middle Cluneal Nerves had mean distances of 2 cm Superior to the PSIS, 0 cm from the PSIS, and 1.5 cm inferior to the PSIS. In their course, the middle Cluneal Nerves traversed the paraspinal muscles attaching onto the dorsal sacrum. Conclusions. Knowledge of the cutaneous Nerves that cross the posterior aspect of the iliac crest may assist in avoiding their injury during bone harvest. Additionally, an understanding of the anatomical pathway that these Nerves take may be useful in decompressive procedures for entrapment syndromes involving the Cluneal Nerves. (DOI: 10.3171/2010.3.SPINE09747) key w o RDS • anatomy • iliac crest • nerve injury • anatomical landmark • gluteal region
Joe Iwanaga - One of the best experts on this subject based on the ideXlab platform.
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anatomic study of Superior Cluneal Nerves revisiting the contribution of lumbar spinal Nerves
World Neurosurgery, 2019Co-Authors: Joe Iwanaga, Emily Simonds, Rod J Oskouian, Maia Schumacher, Shane R TubbsAbstract:Objective Superior Cluneal nerve (SCN) entrapment neuropathy can result in low back pain and thus be confused with other pathologies (e.g., lumbar disk disease). Therefore we performed cadaveric dissection of the SCN to better understand its anatomy and segmental origin. Methods Twenty sides from 10 Caucasian fresh frozen cadavers (6 females and 4 males) were used in this study. The diameter of the SCN, distance between the exit point of the SCN from the thoracolumbar fascia and midline, and distance between the exit point of the SCN from the thoracolumbar fascia and the posterior Superior iliac spine to the medial and lateral SCN were measured. The segmental origins of the SCNs were verified. Results Seventy-five percent of the dorsal rami of L1, 90% of L2, 95% of L3, 45% of L4, and 10% of L5 contributed to the SCN. The SCN was formed by 3 vertebral levels in 55% and by 4 vertebral levels in 30%. Three SCNs pierced the thoracolumbar fascia in 45%. Conclusions The origin of the SCN, which has been described in the textbook and literature for a long time, should be reconsidered on the basis of our study results.
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anatomic study of Superior Cluneal Nerves application to low back pain and surgical approaches to lumbar vertebrae
World Neurosurgery, 2018Co-Authors: Joe Iwanaga, Emily Simonds, Mayank Patel, Rod J Oskouian, Shane R TubbsAbstract:Objective The aim of this study was to investigate the anatomy of the Superior Cluneal Nerves more proximal to the posterior layer of the thoracolumbar fascia. Methods Twelve sides of 6 fresh-frozen cadavers were used. The age at death ranged from 54 to 88 years. After a transverse skin incision 10 mm above the iliac crest, the Superior Cluneal Nerves were detected by blunt dissection and traced back to the dorsal root ganglia. The diameter of the Nerves from L1 to L3 was measured. Also, the relationship to the erector spinae muscle and dorsal ramus was recorded. Results The mean diameters of the origin of the L1, L2, and L3 were 1.71 ± 0.29 mm, 1.73 ± 0.40 mm, and 1.52 ± 0.55 mm, respectively. On 7 sides (58.3%) for L1, seven sides (58.3%) for L2, and 10 sides (83.3%) for L3, the Nerves pierced the iliocostalis muscle. One side (8.3%) for L2 and one (8.3%) for L3 had no cutaneous branch. Conclusions The results of this study could help to elucidate the anatomy of the Superior Cluneal Nerves and help avoid complications during surgical approaches to the lumbar spine.
Philip Cornish - One of the best experts on this subject based on the ideXlab platform.
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ultrasound guided Superior Cluneal Nerves block raising the bar
Regional Anesthesia and Pain Medicine, 2019Co-Authors: Philip CornishAbstract:The ultrasound revolution in regional anesthesia has not surprisingly sparked a surge of interest in anatomy. This is the ‘now we can see it’ phenomenon, and this has rapidly translated to ‘let’s block it’. There is then a temptation to proceed straight to randomized controlled trials of
Emily Simonds - One of the best experts on this subject based on the ideXlab platform.
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anatomic study of Superior Cluneal Nerves revisiting the contribution of lumbar spinal Nerves
World Neurosurgery, 2019Co-Authors: Joe Iwanaga, Emily Simonds, Rod J Oskouian, Maia Schumacher, Shane R TubbsAbstract:Objective Superior Cluneal nerve (SCN) entrapment neuropathy can result in low back pain and thus be confused with other pathologies (e.g., lumbar disk disease). Therefore we performed cadaveric dissection of the SCN to better understand its anatomy and segmental origin. Methods Twenty sides from 10 Caucasian fresh frozen cadavers (6 females and 4 males) were used in this study. The diameter of the SCN, distance between the exit point of the SCN from the thoracolumbar fascia and midline, and distance between the exit point of the SCN from the thoracolumbar fascia and the posterior Superior iliac spine to the medial and lateral SCN were measured. The segmental origins of the SCNs were verified. Results Seventy-five percent of the dorsal rami of L1, 90% of L2, 95% of L3, 45% of L4, and 10% of L5 contributed to the SCN. The SCN was formed by 3 vertebral levels in 55% and by 4 vertebral levels in 30%. Three SCNs pierced the thoracolumbar fascia in 45%. Conclusions The origin of the SCN, which has been described in the textbook and literature for a long time, should be reconsidered on the basis of our study results.
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anatomic study of Superior Cluneal Nerves application to low back pain and surgical approaches to lumbar vertebrae
World Neurosurgery, 2018Co-Authors: Joe Iwanaga, Emily Simonds, Mayank Patel, Rod J Oskouian, Shane R TubbsAbstract:Objective The aim of this study was to investigate the anatomy of the Superior Cluneal Nerves more proximal to the posterior layer of the thoracolumbar fascia. Methods Twelve sides of 6 fresh-frozen cadavers were used. The age at death ranged from 54 to 88 years. After a transverse skin incision 10 mm above the iliac crest, the Superior Cluneal Nerves were detected by blunt dissection and traced back to the dorsal root ganglia. The diameter of the Nerves from L1 to L3 was measured. Also, the relationship to the erector spinae muscle and dorsal ramus was recorded. Results The mean diameters of the origin of the L1, L2, and L3 were 1.71 ± 0.29 mm, 1.73 ± 0.40 mm, and 1.52 ± 0.55 mm, respectively. On 7 sides (58.3%) for L1, seven sides (58.3%) for L2, and 10 sides (83.3%) for L3, the Nerves pierced the iliocostalis muscle. One side (8.3%) for L2 and one (8.3%) for L3 had no cutaneous branch. Conclusions The results of this study could help to elucidate the anatomy of the Superior Cluneal Nerves and help avoid complications during surgical approaches to the lumbar spine.
Rod J Oskouian - One of the best experts on this subject based on the ideXlab platform.
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anatomic study of Superior Cluneal Nerves revisiting the contribution of lumbar spinal Nerves
World Neurosurgery, 2019Co-Authors: Joe Iwanaga, Emily Simonds, Rod J Oskouian, Maia Schumacher, Shane R TubbsAbstract:Objective Superior Cluneal nerve (SCN) entrapment neuropathy can result in low back pain and thus be confused with other pathologies (e.g., lumbar disk disease). Therefore we performed cadaveric dissection of the SCN to better understand its anatomy and segmental origin. Methods Twenty sides from 10 Caucasian fresh frozen cadavers (6 females and 4 males) were used in this study. The diameter of the SCN, distance between the exit point of the SCN from the thoracolumbar fascia and midline, and distance between the exit point of the SCN from the thoracolumbar fascia and the posterior Superior iliac spine to the medial and lateral SCN were measured. The segmental origins of the SCNs were verified. Results Seventy-five percent of the dorsal rami of L1, 90% of L2, 95% of L3, 45% of L4, and 10% of L5 contributed to the SCN. The SCN was formed by 3 vertebral levels in 55% and by 4 vertebral levels in 30%. Three SCNs pierced the thoracolumbar fascia in 45%. Conclusions The origin of the SCN, which has been described in the textbook and literature for a long time, should be reconsidered on the basis of our study results.
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anatomic study of Superior Cluneal Nerves application to low back pain and surgical approaches to lumbar vertebrae
World Neurosurgery, 2018Co-Authors: Joe Iwanaga, Emily Simonds, Mayank Patel, Rod J Oskouian, Shane R TubbsAbstract:Objective The aim of this study was to investigate the anatomy of the Superior Cluneal Nerves more proximal to the posterior layer of the thoracolumbar fascia. Methods Twelve sides of 6 fresh-frozen cadavers were used. The age at death ranged from 54 to 88 years. After a transverse skin incision 10 mm above the iliac crest, the Superior Cluneal Nerves were detected by blunt dissection and traced back to the dorsal root ganglia. The diameter of the Nerves from L1 to L3 was measured. Also, the relationship to the erector spinae muscle and dorsal ramus was recorded. Results The mean diameters of the origin of the L1, L2, and L3 were 1.71 ± 0.29 mm, 1.73 ± 0.40 mm, and 1.52 ± 0.55 mm, respectively. On 7 sides (58.3%) for L1, seven sides (58.3%) for L2, and 10 sides (83.3%) for L3, the Nerves pierced the iliocostalis muscle. One side (8.3%) for L2 and one (8.3%) for L3 had no cutaneous branch. Conclusions The results of this study could help to elucidate the anatomy of the Superior Cluneal Nerves and help avoid complications during surgical approaches to the lumbar spine.