Rhizotomy
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Rhizotomy
::''This article deals with Selective Dorsal Rhizotomy (SDR) rather than the rhizotomy procedures for pain relief; for those procedures, which have begun to take the name "rhizotomy" in certain instances, see facet rhizotomy and similar. A facet rhizotomy is just one of many different forms of radiofrequency ablation, and its use of the "rhizotomy" name should not be confused with the SDR procedure.'' A selective dorsal rhizotomy (SDR), also known as a rhizotomy, dorsal rhizotomy, or a selective posterior rhizotomy, is a neurosurgical procedure that selectively destroys problematic nerve roots in the spinal cord. This procedure has been well-established in the literature as a surgical intervention and is used to relieve negative symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy. The specific sensory nerves inducing spasticity are identified using electromyographic (EMG) stimulation and graded on a scale of 1 (mild) to 4 ...
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Spasticity
Spasticity () is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles. Clinically, spasticity results from the loss of inhibition of motor neurons, causing excessive velocity-dependent muscle contraction. This ultimately leads to hyperreflexia, an exaggerated deep tendon reflex. Spasticity is often treated with the drug baclofen, which acts as an agonist at GABA receptors, which are inhibitory. Spastic cerebral palsy is the most common form of cerebral palsy, which is a group of permanent movement problems that do not get worse over time. GABA's inhibitory actions contribute to baclofen's efficacy as an anti-spasticity agent. Cause Spasticity mostly occurs in disorders of the central nervous system (CNS) affecting the upper motor neurons in the form of a lesion, such as spastic diplegia, or upper mo ...
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Spastic Diplegia
Spastic diplegia is a form of cerebral palsy (CP) that is a chronic neuromuscular condition of hypertonia and spasticity—manifested as an especially high and constant "tightness" or "stiffness"—in the muscles of the lower extremities of the human body, usually those of the legs, hips and pelvis. Doctor William John Little's first recorded encounter with cerebral palsy is reported to have been among children who displayed signs of spastic diplegia. Spastic diplegia accounts for about 22% of all diagnoses of cerebral palsy, and together with spastic quadriplegia and spastic triplegia make up the broad classification spastic cerebral palsy, which accounts for 70% of all cerebral palsy diagnoses. Presentation Individuals with spastic diplegia are very tight and stiff and must work very hard to successfully resist and "push through" the extra tightness they perpetually experience. Other than this, however, these individuals are almost always normal in every significant clinic ...
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Pain Rhizotomy
Radiofrequency ablation (RFA), also called fulguration, is a medical procedure in which part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from medium frequency alternating current (in the range of 350–500 kHz). RFA is generally conducted in the outpatient setting, using either local anesthetics or conscious sedation anesthesia. When it is delivered via catheter, it is called radiofrequency catheter ablation. Two important advantages of radio frequency current (over previously used low frequency AC or pulses of DC) are that it does not directly stimulate nerves or heart muscle and therefore can often be used without the need for general anesthesia, and that it is very specific for treating the desired tissue without significant collateral damage; due to this, it is gaining in popularity as an alternative for eligible patients who do not want to undergo surgery. Documented benefits have led to RFA ...
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Neuritis
Neuritis () is inflammation of a nerve or the general inflammation of the peripheral nervous system. Inflammation, and frequently concomitant demyelination, cause impaired transmission of neural signals and leads to aberrant nerve function. Neuritis is often conflated with neuropathy, a broad term describing any disease process which affects the peripheral nervous system. However, neuropathies may be due to either inflammatory or non-inflammatory causes, and the term encompasses any form of damage, degeneration, or dysfunction, while neuritis refers specifically to the inflammatory process. As inflammation is a common reaction to biological insult, many conditions may present with features of neuritis. Common causes include autoimmune diseases, such as multiple sclerosis; infection, either bacterial, such as leprosy, or viral, such as varicella zoster; post-infectious immune reactions, such as Guillain-Barré syndrome; or a response to physical injury, as frequently seen in s ...
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Hip Flexor
A flexor is a muscle that flexes a joint. In anatomy, flexion (from the Latin verb ''flectere'', to bend) is a joint movement that decreases the angle between the bones that converge at the joint. For example, one’s elbow joint flexes when one brings their hand closer to the shoulder. Flexion is typically instigated by muscle contraction of a flexor. Flexors Upper limb *of the humerus bone (the bone in the upper arm) at the shoulder ** Pectoralis major **Anterior deltoid **Coracobrachialis ** Biceps brachii * of the forearm at the elbow ** Brachialis **Brachioradialis ** Biceps brachii *of carpus (the carpal bones) at the wrist **flexor carpi radialis **flexor carpi ulnaris **palmaris longus *of the hand **flexor pollicis longus muscle **flexor pollicis brevis muscle **flexor digitorum profundus muscle **flexor digitorum superficialis muscle Lower limb Hip The hip flexors are (in descending order of importance to the action of flexing the hip joint):Platzer (2004), p 246 ...
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Dorsal Root
The dorsal root of spinal nerve (or posterior root of spinal nerve or sensory root) is one of two "roots" which emerge from the spinal cord. It emerges directly from the spinal cord, and travels to the dorsal root ganglion. Nerve fibres with the ventral root then combine to form a spinal nerve. The dorsal root transmits sensory information, forming the afferent sensory root of a spinal nerve. Structure The root emerges from the posterior part of the spinal cord and travels to the dorsal root ganglion. The dorsal root ganglia contain the pseudo-unipolar cell bodies of the nerve fibres which travel from the ganglia through the root into the spinal cord. The lateral division of the dorsal root contains lightly myelinated and unmyelinated fibres of small diameter. These carry pain and temperature sensation. These fibers cross through the anterior white commissure to form the anterolateral system in the lateral funiculus. The medial division of the dorsal root contains myelinated ...
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Laminectomy
A laminectomy is a surgical procedure that removes a portion of a vertebra called the lamina, which is the roof of the spinal canal. It is a major spine operation with residual scar tissue and may result in postlaminectomy syndrome. Depending on the problem, more conservative treatments (e.g., small endoscopic procedures, without bone removal) may be viable. Method The lamina is a posterior arch of the vertebral bone lying between the spinous process (which juts out in the middle) and the more lateral pedicles and the transverse processes of each vertebra. The pair of laminae, along with the spinous process, make up the posterior wall of the bony spinal canal. Although the literal meaning of laminectomy is 'excision of the lamina', a conventional laminectomy in neurosurgery and orthopedics involves excision of the supraspinous ligament and some or all of the spinous process. Removal of these structures with an open technique requires disconnecting the many muscles of the bac ...
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Los Angeles
Los Angeles ( ; es, Los Ángeles, link=no , ), often referred to by its initials L.A., is the List of municipalities in California, largest city in the U.S. state, state of California and the List of United States cities by population, second most populous city in the United States after New York City, as well as one of the world's most populous megacities. Los Angeles is the commercial, financial, and cultural center of Southern California. With a population of roughly 3.9 million residents within the city limits , Los Angeles is known for its Mediterranean climate, ethnic and cultural diversity, being the home of the Cinema of the United States, Hollywood film industry, and its Greater Los Angeles, sprawling metropolitan area. The city of Los Angeles lies in Los Angeles Basin, a basin in Southern California adjacent to the Pacific Ocean in the west and extending through the Santa Monica Mountains and north into the San Fernando Valley, with the city bordering the San Gabri ...
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Cauda Equina
The cauda equina () is a bundle of spinal nerves and spinal nerve rootlets, consisting of the second through fifth lumbar nerve pairs, the first through fifth sacral nerve pairs, and the coccygeal nerve, all of which arise from the lumbar enlargement and the conus medullaris of the spinal cord. The cauda equina occupies the lumbar cistern, a subarachnoid space inferior to the conus medullaris. The nerves that compose the cauda equina innervate the pelvic organs and lower limbs to include motor innervation of the hips, knees, ankles, feet, internal anal sphincter and external anal sphincter. In addition, the cauda equina extends to sensory innervation of the perineum and, partially, parasympathetic innervation of the bladder. Structure In adulthood, the cauda equina is made of lumbosacral spinal nerve roots. Development In humans, the spinal cord stops growing in infancy and the end of the spinal cord is about the level of the third lumbar vertebra, or L3, at birth. Becaus ...
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Red Cross War Memorial Children's Hospital
Red Cross War Memorial Children's Hospital in Cape Town, South Africa was opened in 1956 through public subscription as a memorial to soldiers lost in the Second World War. The suggestion that the memorial take the form of a children's hospital was proposed by Vyvyan U.T. Watson. Mr Watson, a prominent businessman, had lost his first born and only son, Peter Tennant Watson, at about four years old, to an outbreak of diphtheria in Cape Town. Mr Watson was a major force in steering the organization of the building of the hospital. The Peter Pan statue on the hospital grounds, sculpted by Ivan Mitford-Barberton, was donated by Mr Watson and his wife, Gwendolyn. Mr Watson was later President of the South African Red Cross Society. It is one of two dedicated children's public hospitals in sub-Saharan Africa, and one of only a few dedicated children's hospitals in the Southern hemisphere. The hospital has academic links to the University of Cape Town's School of Child and Adolescen ...
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Warwick Peacock
Warwick ( ) is a market town, civil parish and the county town of Warwickshire in the Warwick District in England, adjacent to the River Avon. It is south of Coventry, and south-east of Birmingham. It is adjoined with Leamington Spa and Whitnash. It has ancient origins and an array of historic buildings, notably from the Medieval, Stuart and Georgian eras. It was a major fortified settlement from the early Middle Ages, the most notable relic of this period being Warwick Castle, a major tourist attraction. Much was destroyed in the Great Fire of Warwick in 1694 and then rebuilt with fine 18th century buildings, such as the Collegiate Church of St Mary and the Shire Hall. The population was estimated at 37,267 at the 2021 Census. History Neolithic Human activity on the site dates back to the Neolithic, when it appears there was a sizable settlement on the Warwick hilltop. Artifacts found include more than 30 shallow pits containing early Neolithic flints and pottery ...
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Montpellier
Montpellier (, , ; oc, Montpelhièr ) is a city in southern France near the Mediterranean Sea. One of the largest urban centres in the region of Occitania, Montpellier is the prefecture of the department of Hérault. In 2018, 290,053 people lived in the city, while its metropolitan area had a population of 787,705.Comparateur de territoire
INSEE, retrieved 20 June 2022.
The inhabitants are called Montpelliérains. In the Middle Ages, Montpellier was an important city of the (and was the birthplace of ), and ...
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