$Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment$
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Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment

Abstract Entrapments of the intrapelvic portions of the lumbosacral plexus are an important extraspinal cause of sciatica and pudendal neuralgia. They can be treated using Laparoscopic Neuronavigation (LANN), a minimally invasive technique that has set the foundations of an emerging field in Medicin...

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Autores principales:	Nucelio Lemos, Corey Sermer, Gustavo Fernandes, Augusta Morgado-Ribeiro, Andrea Rossos, Zi Ying Zhao, Manuel J. B. C. Girão, Philip Peng
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6e85c028e6fd4eda972bc6f71522f094
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spelling	oai:doaj.org-article:6e85c028e6fd4eda972bc6f71522f0942021-12-02T14:47:38ZLaparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment10.1038/s41598-021-90319-y2045-2322https://doaj.org/article/6e85c028e6fd4eda972bc6f71522f0942021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90319-yhttps://doaj.org/toc/2045-2322Abstract Entrapments of the intrapelvic portions of the lumbosacral plexus are an important extraspinal cause of sciatica and pudendal neuralgia. They can be treated using Laparoscopic Neuronavigation (LANN), a minimally invasive technique that has set the foundations of an emerging field in Medicine—Neuropelveology. This retrospective-prospective study analyzes the outcomes of 63 patients treated with the LANN technique over a 10 year time period. One year after surgery, 78.3% of patients reported clinically relevant pain reduction, defined as ≥ 50% reduction in Numeric Rating Scale (NRS) score; these results were maintained for a mean follow up of 3.2 years. Preoperative chronic opioid use (≥ 4 months of ≥ 10 mg morphine equivalents/day) was a predictor of poor surgical outcome—clinically relevant pain reduction was observed in only 30.8% in this group of patients, compared to 91.5% in patients not regularly taking opioids preoperatively (p < 0.01). Perioperative complication rate was 20%. Our results indicate that the LANN technique is an effective and reproducible approach to relieve pain secondary to intrapelvic nerve entrapments and that preoperative chronic opioid therapy significantly reduces the likelihood of a successful surgical outcome. This study provides detailed information on perioperative complication and postoperative course, which is essential for patient consenting.Nucelio LemosCorey SermerGustavo FernandesAugusta Morgado-RibeiroAndrea RossosZi Ying ZhaoManuel J. B. C. GirãoPhilip PengNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Nucelio Lemos Corey Sermer Gustavo Fernandes Augusta Morgado-Ribeiro Andrea Rossos Zi Ying Zhao Manuel J. B. C. Girão Philip Peng Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment
description	Abstract Entrapments of the intrapelvic portions of the lumbosacral plexus are an important extraspinal cause of sciatica and pudendal neuralgia. They can be treated using Laparoscopic Neuronavigation (LANN), a minimally invasive technique that has set the foundations of an emerging field in Medicine—Neuropelveology. This retrospective-prospective study analyzes the outcomes of 63 patients treated with the LANN technique over a 10 year time period. One year after surgery, 78.3% of patients reported clinically relevant pain reduction, defined as ≥ 50% reduction in Numeric Rating Scale (NRS) score; these results were maintained for a mean follow up of 3.2 years. Preoperative chronic opioid use (≥ 4 months of ≥ 10 mg morphine equivalents/day) was a predictor of poor surgical outcome—clinically relevant pain reduction was observed in only 30.8% in this group of patients, compared to 91.5% in patients not regularly taking opioids preoperatively (p < 0.01). Perioperative complication rate was 20%. Our results indicate that the LANN technique is an effective and reproducible approach to relieve pain secondary to intrapelvic nerve entrapments and that preoperative chronic opioid therapy significantly reduces the likelihood of a successful surgical outcome. This study provides detailed information on perioperative complication and postoperative course, which is essential for patient consenting.
format	article
author	Nucelio Lemos Corey Sermer Gustavo Fernandes Augusta Morgado-Ribeiro Andrea Rossos Zi Ying Zhao Manuel J. B. C. Girão Philip Peng
author_facet	Nucelio Lemos Corey Sermer Gustavo Fernandes Augusta Morgado-Ribeiro Andrea Rossos Zi Ying Zhao Manuel J. B. C. Girão Philip Peng
author_sort	Nucelio Lemos
title	Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment
title_short	Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment
title_full	Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment
title_fullStr	Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment
title_full_unstemmed	Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment
title_sort	laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6e85c028e6fd4eda972bc6f71522f094
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Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment

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