Study Design: Prospective observational pilot study. OBJECTIVE.: To investigate the effect of right and left radiculopathy on driver reaction time (DRT), and the effect of selective nerve root block (SNRB) on DRT.
Summary Of Background Data: The effect of many orthopedic procedures on DRT has already been assessed. To date the effect of radiculopathy and SNRB on DRT has not been studied.
Methods: DRTs of 20 radiculopathic patients (10 right, 10 left) were measured using a custom-built car simulator. Each patient was tested pre-SNRB, immediately post-SNRB, and 2 and 6 weeks post-SNRB. As controls 20 age- and sex-matched normal subjects were tested once. Full departmental, institutional, and ethical committee approval were obtained.
Results: Mean DRT of the control group was 452 milliseconds. Mean DRT of patients with right or left radiculopathy pre-SNRB was 521 milliseconds (P < 0.045) and 535 milliseconds (P < 0.018), respectively. In the right radiculopathic group, the measurements immediately post-SNRB, 2 weeks, and 6 weeks were 656 milliseconds (P < 0.005), 589 milliseconds (P < 0.019), and 564 milliseconds (P < 0.10), respectively. The delay immediately and at 2 weeks post-SNRB translates into an increase in stopping distance of 3.8 and 1.9 m, respectively at the speed of 100 km/h. In the left radiculopathic group, the measurements immediately post-SNRB, 2 weeks, and 6 weeks were 585 milliseconds (P < 0.037), 534 milliseconds, and 530 milliseconds, respectively. The delay immediately post-SNRB translates into an increase in stopping distance of 1.4 m at the speed of 100 km/h.
Conclusion: The study identified significant DRTs' changes both in radiculopathy and after SNRB. Right and left radiculopathic patients should be advised about the possible changes in their DRTs post-SNRB. Future research with regard to the suitability for radiculopathic patients to drive and the best time to resume driving post-SNRB is needed.
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http://dx.doi.org/10.1097/BRS.0b013e31817b5bb7 | DOI Listing |
J Neurosurg Spine
July 2024
3Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
Br J Pain
August 2022
Pain Management Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Purpose: Although spinal cord stimulation (SCS) is a safe procedure, equipment-related, biological and neurological complications have been observed in previous research, particularly case reports. No reports of new neuropathic pain in the absence of neurological deficit or positive MRI findings have been described. We detail three cases of new-onset radicular pain in the L5/S1 dermatome following insertion of SCS.
View Article and Find Full Text PDFCureus
July 2022
Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, IND.
Giant Tarlov cysts are described as fluid-filled sacs located in the spine. They are mostly found in the sacral region, but are usually asymptomatic. The symptomatic Tarlov cysts are planned for surgical treatment in the form of laminectomy and marsupilisation of cysts.
View Article and Find Full Text PDFActa Neurochir (Wien)
April 2021
Department of Neurosurgery, King's College Hospital, London, UK.
Introduction: Isolated acute bilateral foot drop due to degenerative spine disease is an extremely rare neurosurgical presentation, whilst the literature is rich with accounts of chronic bilateral foot drop occurring as a sequela of systemic illnesses. We present, to our knowledge, the largest case series of acute bilateral foot drop, with trauma and relevant systemic illness excluded.
Methods: Data from three different centres had been collected at the time of historic treatment, and records were subsequently reviewed retrospectively, documenting the clinical presentation, radiological level of compression, timing of surgery, and degree of neurological recovery.
Pain Med
September 2021
Department of Pain Management Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Objective: The aim of the present study was to investigate the effectiveness and safety of a novel lateral in-plane approach for ultrasound-guided transforaminal cervical nerve root block (US-guided TF-CNRB) in the treatment of cervical radiculopathic pain.
Design: The design of the present study consisted of an institutional, retrospective case series.
Setting: The present study was conducted at a university hospital.
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