Publications by authors named "Isu T"

Background: Tarsal tunnel syndrome (TTS) is a common entrapment neuropathy of the posterior tibial nerve. Surgery can be performed less invasively under local anesthesia. We adopted zig-zag skin incision to prevent postoperative wound complications.

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Introduction: Middle cluneal nerve (MCN) entrapment around the sacroiliac joint elicits low back pain (LBP). For surgical decompression to be successful, the course of the MCN must be known. We retrospectively studied the MCN course in 15 patients who had undergone MCN neurolysis.

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Introduction Low back pain (LBP) is a major contributor to decreases in the ability to perform activities of daily living (ADL) in older adults. Paralumbar spine disease (PLSD) is a common cause of LBP. We aimed to investigate the causes of LBP, including PLSD, among older adults.

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Background: Tarsal tunnel syndrome (TTS) is a common entrapment neuropathy that is sometimes elicited by ganglia in the tarsal tunnel.

Methods: Between August 2020 and July 2022, we operated on 117 sides with TTS. This retrospective study examined data from 8 consecutive patients (8 sides: 5 men, 3 women; average age 67.

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Article Synopsis
  • - Low back pain (LBP) can be linked to the entrapment of the superior cluneal nerve (SCN) near the iliac crest, and a surgical approach can help alleviate the issue, but identifying all entrapped nerves is a challenge.
  • - A study with 20 patients (average age 72.5) developed a 3-step surgery procedure to decompress SCNs, discovering a total of 66 nerves across all patients, with varying success at each step.
  • - The research concluded that the SCN is most easily identified when the thoracolumbar fascia is first opened; the proposed 3-step method enhances nerve identification during surgery.
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  • The middle cluneal nerve (MCN) is a sensory nerve located in the buttock, and its entrapment can cause low back pain (LBP), which can be treated surgically through procedures like neurectomy.
  • A study involving 6 patients with chronic LBP who underwent MCN neurectomy showed significant improvement in their pain and disability scores post-surgery, with follow-up demonstrating long-term relief.
  • Pathological analysis of the resected MCNs revealed various abnormalities such as decreased fiber density and thickening of the perineurium, indicating that MCN entrapment is a potential cause of LBP.
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Purpose: Entrapment of the middle cluneal nerve (MCN-E) can elicit low back pain (LBP). Patients whose LBP responds only transiently to the analgesic effects of MCN blockage may be candidates for surgery. This study addresses its long-term efficacy.

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Transarticular screw fixation is a method for posterior cervical fixation. It is ergonomic because neither connectors nor rods are needed. Biomechanical studies have shown that its fixation force is not inferior to that of lateral mass screws.

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In idiopathic tarsal tunnel syndrome (TTS), walking seems to make symptoms worse. The findings imply that an ankle movement dynamic component may have an impact on the etiology of idiopathic TTS. We describe how the ankle movement affects the nerve compression caused by the surround tissue, particularly the posterior tibial artery.

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We compared the treatment satisfaction of patients who had undergone surgery for tarsal tunnel syndrome (TTS) and carpal tunnel syndrome (CTS). We enrolled 44 patients in this study; 23 were operated for CTS and 21 for TTS. All patients had received surgery under a microscope and under local anesthesia.

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Tarsal tunnel syndrome (TTS) is a common entrapment syndrome whose diagnosis can be difficult. We compared preoperative magnetic resonance imaging (MRI) and operative findings in 23 consecutive TTS patients (28 sides) whose mean age was 74.5 years.

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Aneurysms of the recurrent artery of Heubner (RAH) are known to be one of the uncommon cerebral aneurysms, predominantly presenting with bleeding symptoms. Previously, nine cases of the RAH aneurysms have been reported, all of which were treated surgically or endovascularly and most cases developed postoperative cerebral infarct in the ipsilateral caudate nucleus. Herein, we report a man presenting with transient ischemic attack due to diffuse cerebral vasospasm from a minor non-disabling subarachnoid hemorrhage (SAH) from an RAH aneurysm.

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Introduction: Low back pain (LBP) from superior or middle cluneal nerve entrapment has been addressed surgically. We recorded patient satisfaction with this treatment.

Methods: We included 22 consecutive patients who had undergone surgery for unilateral cluneal nerve entrapment (superior: n = 17, middle: n = 5).

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Article Synopsis
  • The text discusses a case of common peroneal nerve (C-PN) entrapment neuropathy and highlights a rare complication following surgery aimed at relieving the condition.
  • An 85-year-old man experienced paralysis immediately after C-PN decompression surgery due to improper suturing that compressed the nerve, which was resolved by reopening the incision and releasing the suture.
  • The conclusion emphasizes the need for careful postoperative monitoring in peripheral nerve surgeries to prevent complications, as timely intervention can lead to better outcomes.
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Peripheral nerve diseases are common. Para-lumbar spine diseases (PLSDs) include peripheral neuropathy around the lumbar spine, e.g.

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  • - Lymphomatoid granulomatosis (LYG) is a rare condition linked to the Epstein-Barr virus that primarily affects the lungs but can also impact other organs such as the skin, liver, and central nervous system, with rare occurrences in the spine.
  • - A systematic review identified 15 cases of spinal LYG, showing that the average patient was 43.4 years old, predominantly male, and most had brain lesions alongside spinal involvement; diagnostic methods primarily involved biopsies.
  • - The prognosis for spinal LYG is concerning, with a mean follow-up of 21.6 months revealing that 4 out of 15 patients died despite receiving various treatments, indicating a need for more research to understand
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Background: Middle cluneal nerve entrapment neuropathy (MCN-EN) is a known cause of low back pain (LBP). Here, we succeeded in treating a patient with a lumbar disc herniation who actually had MCN-EN with a nerve block and neurolysis.

Case Description: A 52-year-old female presented with severe left lower back and lateral thigh pain making it difficult to walk.

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As superficial peroneal nerve (S-PN) entrapment neuropathy is relatively rare, it may be an elusive clinical entity. For decompression surgery addressing idiopathic S-PN entrapment, narrow-area decompression may be insufficient and long-area decompression along the S-PN from the peroneus longus muscle (PLM) to the peroneal nerve exit site may be required. To render it is less invasive, we performed S-PN neurolysis in a combined microscope/endoscope procedure.

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  • Meralgia paresthetica (MP) is a rare nerve problem affecting the lateral femoral cutaneous nerve that can occur after microvascular decompression (MVD) surgery, particularly when performed in a park-bench position.
  • A 46-year-old woman experienced thigh pain and sensory issues after a second MVD for hemifacial spasm, leading to a diagnosis of MP that was confirmed months later after conservative treatments failed.
  • Administering an LFCN block significantly improved her symptoms, and there has been no recurrence of MP after 30 months, although she still experiences mild sensory changes.
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Background: Entrapment of the middle cluneal nerve (MCN), a peripheral nerve in the buttock, can elicit low back pain (LBP). We examined the epidemiology, clinical course, and treatment of MCN entrapment (MCN-EN).

Methods: Among 383 LBP patients who visited our institute, 105 were admitted for intractable LBP.

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A 51-year-old man had a 1-year history of numbness on the ulnar side of the 4th finger, the 5th finger, and the ulnar side of the forearm, and weakness of the right hand. The Spurling sign was negative, and cervical radiography and magnetic resonance imaging revealed no abnormality. The Tinel-like signs at the Guyon's canal and cubital tunnel were positive.

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Study Design: Retrospective study.

Purpose: This study aims to evaluate the effectiveness of mirogabalin in treatment of peripheral neuropathic pain due to lumbar spine disease.

Overview Of Literature: Mirogabalin is a novel selective ligand for the α2δ subunit of voltage-gated Ca channels.

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Lumbar disc herniation (LDH) elicits low back pain (LBP) and lower-limb symptoms. Paralumbar spine disease (PLSD), for example, superior cluneal nerve/middle cluneal nerve entrapment (SCN-EN, MCN-EN) and sacroiliac joint pain (SIJ), may be attributable to LDH whose treatment may not ameliorate their symptoms. We treated LDH patients and addressed their coexisting PLSDs.

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Background: Surgery for idiopathic tarsal tunnel syndrome (TTS) is of limited effectiveness or ineffective. Using indocyanine green video angiography (ICG-VA), we treated idiopathic TTS by posterior tibial artery (PTA) decompression from the posterior tibial nerve (PTN) and evaluated postoperative patency of the PTA.

Methods: We treated 12 patients (12 feet) with idiopathic TTS by PTA decompression from the PTN and transposed its location.

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Article Synopsis
  • The study investigates the effectiveness of radiofrequency thermocoagulation (RFTC) as a treatment for middle cluneal nerve entrapment (MCN-E) causing low back pain in elderly patients.
  • Eleven patients with chronic buttock pain underwent RFTC, reporting significant pain relief and no complications; treatment effectiveness was monitored over 24 weeks.
  • While initial pain reduction showed immediate results, the full benefits on disability were observed after 12 weeks, indicating that RFTC can provide a long-lasting solution for MCN-E-related pain.
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