The Experts below are selected from a list of 17067 Experts worldwide ranked by ideXlab platform
A. Lee Dellon - One of the best experts on this subject based on the ideXlab platform.
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Soleal sling syndrome (proximal Tibial Nerve compression): results of surgical decompression.
Plastic and reconstructive surgery, 2012Co-Authors: Eric H. Williams, Gedge D. Rosson, Robert Hagan, Shahreyar S. Hashemi, A. Lee DellonAbstract:Background:Although distal Tibial Nerve compression is well recognized, proximal Tibial Nerve compression remains a rarely recognized clinical condition. This report defines the presentation, diagnosis, surgical decompression technique, and clinical outcome of neurolysis of the Tibial Nerve at this
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Combined peroneal and proximal Tibial Nerve palsies.
Microsurgery, 2009Co-Authors: Eric H. Williams, Christopher G. Williams, Gedge D. Rosson, A. Lee DellonAbstract:Combined compression of both the common peroneal Nerve and the proximal Tibial Nerve at the level of the popliteal fossa is rare. Recently, an anatomic site of compression of the proximal Tibial Nerve at the soleal sling (originating arch for the soleus muscle) has been described in cadavers. The present report includes three patients who had a combined compression of the common peroneal Nerve at the fibular neck (fibular tunnel syndrome) and compression of the proximal Tibial Nerve at the soleal sling (soleal sling syndrome). In each case, blunt trauma was the precipitating event. Neurolysis of both Nerves resulted in restoration of motor and sensory function in each ofthese three patients. This is the first clinical report illustrating combined neurolysis of the common peroneal at the knee and the proximal Tibial Nerve in the soleal sling. © 2009 Wiley-Liss, Inc. Microsurgery, 2009.
Paul B. Yoo - One of the best experts on this subject based on the ideXlab platform.
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An Enhanced Method of Transcutaneously Stimulating the Tibial Nerve for the Treatment of Overactive Bladder.
Annals of biomedical engineering, 2017Co-Authors: Mario Kovacevic, Richard Lin, Paul B. YooAbstract:Transcutaneous electrical Nerve stimulation (TENS) can be used to electrically stimulate the Tibial Nerve for the purpose of treating overactive bladder. Although clinical benefits can be achieved, the overall therapeutic efficacy of TENS is limited. Inconsistent activation of the intended neural target and co-activation of cutaneous sensory fibers are considered key limiting factors. In this study, we propose a novel approach that combines TENS with an implanted, electrically-conductive Nerve cuff to reduce the stimulation amplitude needed to activate the Tibial Nerve. This enhanced version of TENS (called eTENS) was designed using a computational model of the rat Tibial Nerve and subsequently tested in anesthetized rats. Our computational model showed that eTENS can reduce the Nerve activation threshold by a factor of up to 2.6. Similar effects were also achieved by in vivo experiments (1.4 ± 0.1-fold decrease, n = 5). Among various design parameters, spatial alignment between the surface electrode and the Nerve cuff was identified as an important factor. Our results show that eTENS can improve the selective activation of the rat Tibial Nerve, but further work is needed to evaluate its use in clinical therapies.
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Reflex neuromodulation of bladder function elicited by posterior Tibial Nerve stimulation in anesthetized rats
American journal of physiology. Renal physiology, 2014Co-Authors: Mario Kovacevic, Paul B. YooAbstract:Although posterior Tibial Nerve stimulation (PTNS) has been shown in both clinical and animal studies to elicit bladder-inhibitory reflexes, our understanding of the role of posterior Tibial Nerve ...
Michael D Millen - One of the best experts on this subject based on the ideXlab platform.
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femoral artery ischemia during spinal scoliosis surgery detected by posterior Tibial Nerve somatosensory evoked potential monitoring
Spine, 2000Co-Authors: David G Vossler, Thomas Stonecipher, Michael D MillenAbstract:Study Design. A case report of unilateral leg ischemia caused by femoral artery compression detected using posterior Tibial Nerve somatosensory-evoked potentials during spinal scoliosis instrumentation surgery. Objectives. To report a rare cause of intraoperative unilateral loss of all posterior Tibial Nerve somatosensory-evoked potential waveforms. Summary of Background Data. Failure to obtain adequate popliteal fossa, spinal, subcortical, and cortical potentials during posterior Tibial Nerve somatosensory-evoked potential spinal cord monitoring usually results from technical factors or chronic conditions affecting the peripheral Nerve. Methods. A 16-year-old boy with thoracic scoliosis had normal posterior Tibial Nerve somatosensory-evoked potentials both before surgery and in the operating room immediately after anesthesia induction and prone positioning on a four-post spinal frame. Results. One hour after the start of surgery, a minimal amplitude reduction of the right popliteal fossa potentials appeared. Fifteen minutes later, the amplitudes of the popliteal fossa, subcortical, and cortical potentials evoked by right posterior Tibial Nerve stimulation became substantially reduced. Subsequently, all waveforms were lost. Malfunction of the right posterior Tibial Nerve stimulator was initially suspected, but when proper function was verified, a search for other causes of this loss led to discovery of leg ischemia. The patient was repositioned on the spinal frame, and all posterior Tibial Nerve somatosensory-evoked potentials waveforms began to reappear 7 minutes later. There was no postoperative clinically detectable complication. Conclusions. Although technical malfunction should always be suspected when all intraoperative somatosensory-evoked potential waveforms are initially seen and subsequently lost, one should also consider the possibility that intraoperative ischemia due to limb positioning could be the etiology.
Eric H. Williams - One of the best experts on this subject based on the ideXlab platform.
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Soleal sling syndrome (proximal Tibial Nerve compression): results of surgical decompression.
Plastic and reconstructive surgery, 2012Co-Authors: Eric H. Williams, Gedge D. Rosson, Robert Hagan, Shahreyar S. Hashemi, A. Lee DellonAbstract:Background:Although distal Tibial Nerve compression is well recognized, proximal Tibial Nerve compression remains a rarely recognized clinical condition. This report defines the presentation, diagnosis, surgical decompression technique, and clinical outcome of neurolysis of the Tibial Nerve at this
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Combined peroneal and proximal Tibial Nerve palsies.
Microsurgery, 2009Co-Authors: Eric H. Williams, Christopher G. Williams, Gedge D. Rosson, A. Lee DellonAbstract:Combined compression of both the common peroneal Nerve and the proximal Tibial Nerve at the level of the popliteal fossa is rare. Recently, an anatomic site of compression of the proximal Tibial Nerve at the soleal sling (originating arch for the soleus muscle) has been described in cadavers. The present report includes three patients who had a combined compression of the common peroneal Nerve at the fibular neck (fibular tunnel syndrome) and compression of the proximal Tibial Nerve at the soleal sling (soleal sling syndrome). In each case, blunt trauma was the precipitating event. Neurolysis of both Nerves resulted in restoration of motor and sensory function in each ofthese three patients. This is the first clinical report illustrating combined neurolysis of the common peroneal at the knee and the proximal Tibial Nerve in the soleal sling. © 2009 Wiley-Liss, Inc. Microsurgery, 2009.
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Anatomic site for proximal Tibial Nerve compression: a cadaver study.
Annals of plastic surgery, 2009Co-Authors: Eric H. Williams, Christopher G. Williams, Gedge D. Rosson, Lee A. DellonAbstract:Primary compression of the Tibial Nerve beneath the fibromuscular sling of the origin of the soleus muscle is rarely discussed in the literature. To evaluate the location and characteristics of the soleal fibromuscular sling and its relationship to the Tibial Nerve, 36 cadaver limbs were dissected. The leg length, location of soleal fibromuscular sling, presence of a thickened fibrous band at the soleal sling, and narrowing in the Tibial Nerve were recorded. The average leg length was 47.8 cm (SD +/- 4.16). The fibromuscular soleal sling was 9.3 cm (SD +/- 1.44) distal to the medial Tibial plateau. Although 56% (20/36) of specimens had a fibrous band, only 8% (3/36) demonstrated a focal narrowing directly under this fascial sling. This study demonstrates that the fibromuscular sling of the soleus muscle may act as a potential compression site of the Tibial Nerve. These findings offer insight and potential hope for those patients who have persistent plantar numbness after tarsal tunnel decompression and for those patients with plantar numbness who also have weakness of toe flexion.
Vik. Khullar - One of the best experts on this subject based on the ideXlab platform.
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Posterior Tibial Nerve stimulation for overactive bladder—techniques and efficacy
International Urogynecology Journal, 2019Co-Authors: Alka A. Bhide, Visha Tailor, Ruwan Fernando, Vik. Khullar, Giuseppe Alessandro DigesuAbstract:The ideal treatment for overactive bladder is still elusive. In those where medication fails to improve symptoms options include invasive treatments such as botulinum toxin-A, sacral neural stimulation or posterior Tibial Nerve stimulation. Scientific professional society guidelines advise percutaneous posterior Tibial Nerve stimulation as a third line treatment option only after multi-disciplinary team review as well as failure of both conservative and pharmacological management. The aim of this article is to review all techniques for Tibial Nerve stimulation and their efficacy.
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Posterior Tibial Nerve stimulation for overactive bladder-techniques and efficacy.
International urogynecology journal, 2019Co-Authors: Alka Bhide, Visha Tailor, Ruwan Fernando, Vik. Khullar, Giuseppe Alessandro DigesuAbstract:The ideal treatment for overactive bladder is still elusive. In those where medication fails to improve symptoms options include invasive treatments such as botulinum toxin-A, sacral neural stimulation or posterior Tibial Nerve stimulation. Scientific professional society guidelines advise percutaneous posterior Tibial Nerve stimulation as a third line treatment option only after multi-disciplinary team review as well as failure of both conservative and pharmacological management. The aim of this article is to review all techniques for Tibial Nerve stimulation and their efficacy.
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Percutaneous Tibial Nerve stimulation for overactive bladder
Nature Reviews Urology, 2010Co-Authors: Rufus Cartwright, Vik. KhullarAbstract:Before 2009, no controlled trials of percutaneous Tibial Nerve stimulation (PTNS) for overactive bladder had been reported. However, publication of a randomized unblinded tolterodine-controlled trial of PTNS and the reporting of two blinded placebo-controlled studies now provide level 1b evidence of efficacy. PTNS should, therefore, be considered as a treatment option in this setting.
