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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dermatomes of rats from C1 to T1 (forelimb) and from T12 to S2 (hindlimb) were determined by electrical stimulation of spinal nerves following the intravenous administration of Evans blue. After stimulation of the ventral ramus of a spinal nerve, a blue spotted area presenting the maximal innervation area of the spinal nerve appeared in the skin. Maximal innervation areas generally overlapped the adjacent areas. Each digit was innervated by two to three spinal nerves. Composite dermatomes were determined where boundary lines were defined as the midline of overlapping areas. Based on the composite dermatomes, boundary lines in the rat fore- and hindlimbs were revealed to loop around the antero-posterior axis showing a V-shaped pattern in the anterior and posterior aspects and converge to the ventral and dorsal midlines of the limb. The present dermatome chart may be applied to research concerning the segmental distribution of sensory C-fibers.
Pain 1996 Sep
PMID:Dermatomes in the rat limbs as determined by antidromic stimulation of sensory C-fibers in spinal nerves. 889 48

1. Stimulation of the ureter in humans evokes only painful sensations. A large proportion of ureteric afferents show high activation thresholds to ureter pressure increases and encode stimuli within the noxious range. However, little is known about how these properties are reflected in the central processing of ureteric information. In this study, dorsal horn neurons recorded in the left side of the T12-L1 spinal cord of anesthetized rats have been tested for responses to innocuous and noxious pressure stimuli applied to the ipsilateral ureter. 2. Single-unit recordings were made from 76 neurons with somatic receptive fields on the left flank, of which 57 were fully characterized and tested by raising the ureter pressure to 80 mmHg for 30 s. Of these 57 neurons, 24 (42%) were influenced by the ureter stimulus, as follows: 18 were excited, 2 were inhibited, and 4 showed changes in background activity and/or in somatic receptive field area, without a time-locked change in firing rate. The remaining 33 cells (58%) showed no changes in firing rate, background activity, somatic receptive field area, or input properties as a result of ureter stimulation. 3. Neurons responding to the 80-mmHg stimulus were further tested with a range of ureter pressures (5-100 mmHg). No responses were evoked by stimuli of < 20 mmHg, and responses observed were proportional to stimulus intensity. Excitatory responses showed a long onset latency (median = 23 s) and long afterdischarges (median = 145 s). 4. All neurons with ureter input had nociceptive somatic inputs. When compared with neurons without ureter input, cells with ureter input were more likely to show background activity (80 vs. 27%) and more likely to have bilateral somatic receptive fields (30 vs. 6%). Neurons with ureter input had higher rates of background activity and larger somatic receptive fields. Ureter stimulation also produced changes in the somatic receptive field area of neurons excited or inhibited by the stimulus, indicating a high degree of plasticity in the ureteric nociceptive pathway. 5. We conclude that the characteristics of the responses of dorsal horn neurons with ureter input to noxious and innocuous ureter stimulation indicate that they receive ureteric input mainly from high-threshold afferents, and that their response properties correlate well with ureteric pain sensation in humans.
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PMID:Spinal dorsal horn neurons responding to noxious distension of the ureter in anesthetized rats. 893 Feb 69

Charcot spine, also known as neuropathic spinal arthropathy, is a late complication of traumatic spinal cord injury that can produce pain and further disability. We report five cases of Charcot spine occurring in patients with previous traumatic spinal cord injury that we have identified at our institution from 1985 to 1994. All patients had complete paraplegia with levels of neurologic injury ranging from T7 to T12. Common presenting symptoms included back pain, loss of spasticity, change in bladder function, and audible noises with motion. The diagnosis of Charcot spine was made from 6 to 31 years after original spinal cord injury. In four cases where a surgical fusion had been performed, the Charcot joint developed within two spinal segments below the caudal end of the fusion. Radiological studies, especially plain films and computed tomography, were helpful in making the diagnoses. Immobilization of the affected joint is an essential element of treatment. Surgical repair and stabilization were performed in four patients and has been recommended to the other patient. Early diagnosis and proper treatment is important in preventing the progression of this disorder.
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PMID:Charcot spine as a late complication of traumatic spinal cord injury. 904 6

From 1981 to 1994, 16 patients with 18 thoracic disk hernias due to degenerative disease (n = 13), trauma (n = 4) or Scheuermann's disease (n = 1) received surgical treatment. Most were situated from T6 to T12. There were 10 medial hernias and 8 lateral hernias. Symptom duration was a mean 23 months at surgery including spinal pain (n = 13) and spinal syndrome (n = 9). Posterolateral access was used in 13 cases and the anterior route in 2, both requiring a graft. After a follow-up of 5 years 1 month, functional and subjective results were excellent or good in 83% of the cases, acceptable in 6% and poor in 11%. Two failures with the posterolateral route corresponded to one patient with initial trauma-induced paraplegia and another with neurological aggravation after the first laminectomy. In our experience, the posteriolateral route is preferred to allow good visual control even in cases involving several levels. Secondary laminectomy may be performed without risking displacement. The presence of the Adamkiewicz artery on the same side and at the same level dictates use of the anterior route which may soon be replaced by video-assisted thoracoscopy to avoid resection of the rib.
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PMID:[Surgical treatment of symptomatic thoracic disk hernia: anterior or posterolateral approach?]. 909 Dec 76

Dorsal column stimulation (DCS) is used clinically to provide pain relief from peripheral vascular disease and has the benefit of increasing cutaneous blood flow to the affected lower extremities. The purpose of this study was to examine the role of dorsal roots, calcitonin gene-related peptide (CGRP), and substance P in the cutaneous vasodilation induced by DCS. Male rats were anesthetized with pentobarbital sodium (60 mg/kg ip). A unipolar ball electrode was placed unilaterally on the spinal cord at the L1-L2 spinal segment. Blood flow was recorded in each hindpaw foot pad with laser Doppler flowmeters. Blood flow responses were assessed during 1 min of DCS (either 0.2 mA subdural or 0.6 mA epidural at 50 Hz, 0.2-ms pulse duration). Dorsal rhizotomy of L3-L5 (n = 5) abolished the cutaneous vasodilation to subdural DCS, whereas removal of T10-T12 (n = 5) and T13-L2 dorsal roots (n = 5) did not attenuate the DCS-induced vasodilation. The CGRP antagonist, CGRP-(8-37) (2.6 mg/kg iv, n = 7), eliminated the epidural DCS-induced vasodilation, whereas the substance P receptor antagonist, CP-96345 (1 mg/kg iv, n = 6), had no effect. In summary, L3-L5 dorsal roots and CGRP are essential for the DCS-induced vasodilation. We propose that DCS antidromically activates afferent fibers in the dorsal roots, thus causing peripheral release of CGRP, which produces cutaneous vasodilation.
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PMID:Cutaneous vasodilation during dorsal column stimulation is mediated by dorsal roots and CGRP. 912 59

Thoracic diabetic radiculopathy causing truncal pain and abdominal muscle bulging is a recognized though extremely rare complication of diabetes. We report here six cases, describing their clinical features and natural history in detail: the condition affects predominantly middle-aged men, usually on the right side of the abdominal wall, involving three to five adjacent nerve roots between T6 and T12. It may be accompanied by profound weight loss which is not normally due to poorly controlled diabetes. Complete resolution of this syndrome occurs after 3 to 12 months.
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PMID:Unilateral abdominal muscle herniation with pain: a distinctive variant of diabetic radiculopathy. 930 Feb 33

The cases of two patients with inguinal pain as the only symptom of a T12 metastatic lesion is reported. The patterns of pain referrals from tumor lesions to the spine, epidural space, and spinal cord are reviewed. Focal back pain and pain reported in a distal distribution can both be associated with epidural or cord disease. The differential diagnosis of back pain in patients with cancer can be difficult but may be crucial in differentiating important neurological complications of systemic neoplasms.
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PMID:Pain due to epidural tumor in cancer patients. Report of two cases and differential diagnosis. 941 57

This study evaluates the technique and results of video-assisted thoracoscopic surgery (VATS) for the treatment of symptomatic thoracic disc herniation. Results were compared with a literature review of open surgical techniques of thoracic disc excision with regard to efficacy, safety, and surgical outcomes. VATS has recently been described for thoracic surgery as having the advantage of decreased postoperative pain and morbidity, faster patient recovery, and shortened intensive care unit (ICU) hospitalization. Twenty-nine consecutive patients underwent VATS for symptomatic thoracic disc herniation. Herniations ranging from T5-6 to T12-L1 were successfully approached by using a three- or four-portal strategy. Postoperative magnetic resonance imaging (MRI) scans were evaluated. Pre- and postoperative Oswestry Disability Questionnaires and Linear Analog Pain Scale data were obtained. Patients were grouped according to presenting symptoms. The minimal follow-up was 1 year (range, 12-24 months). Mean operative time was 175 min for 29 patients. Significant improvement (p < 0.01, paired t test) was recorded in Oswestry Disability Questionnaires and Linear Analog Scale Tests. Of the patients, 75.8% (22) were satisfied, 3.4% (one) unsatisfied, with 20.1% (six) unchanged. Narcotic use was significantly eliminated or reduced. Mean return to work was 5 weeks (private insurance) and 21 weeks (workers compensation). The surgical and postoperative complication rate was 13.8%. VATS appears to be a safe and efficacious method of excising herniated thoracic discs. Follow-up results at 1 year resulted in high patient satisfaction. VATS advantages include decreased length of hospitalization as well as improved patient comfort.
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PMID:Video-assisted thoracoscopic excision of herniated thoracic disc: description of technique and preliminary experience in the first 29 cases. 965 40

A 19-year-old boy with a painful thoracolumbar scoliosis was found to have an osteoblastoma of the body of T12. Excision of the tumour was carried out through a left thoracotomy approach and strut bone grafting was performed. Complete excision of the tumour was facilitated by intraoperative radiographs of the removed vertebra. Following surgery the patient's pain resolved completely and the deformity was partially corrected. Osteoblastoma of the vertebral body in the thoracolumbar region has not previously been reported. Diagnosis may be difficult unless the significance of the association between pain and the scoliosis is appreciated. The tumour is often not readily apparent on plain radiographs. Therefore, further radiological investigation in the form of a bone and CT scan is necessary to establish the diagnosis. Early excision of the tumour is essential to prevent a permanent structural scoliosis from developing.
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PMID:Painful scoliosis secondary to osteoblastoma of the vertebral body. 968 60

Neurilemoma of the spinal cord occurred in a mother and daughter. Case 1 was a 75-year-old woman with gait disturbance. Examination revealed weakness of the lower extremities, and magnetic resonance (MR) imaging showed an intradural extramedullary tumor at T12. After laminectomy, the histologic diagnosis was mixed Antoni type A and B neurilemoma. Case 2 was a 48-year-old woman (daughter of case 1). She presented with cervical pain and numbness of both hands. Examination revealed weakened intrinsic muscles of the right hand and paresthesia of the right upper arm. MR imaging showed a giant hourglass-shaped extradural tumor at C2 and C3. The histologic diagnosis was Antoni type A neurilemoma. Only six families with neurilemoma have been reported, including our patients. Gene analysis of such patients may clarify the etiology of neurilemoma.
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PMID:Familial neurilemoma of the spinal cord in a mother and daughter. 972 9


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