Paralabral cysts of the shoulder are rare, and there are few reports available that describe anteroinferior paralabral cysts arising from a detached antero-inferior glenoid labral tear without shoulder instability. We report an antero-inferior labral tear without shoulder instability in adolescent overhead athlete associated with paralabral cyst that leads to axillary nerve neurapraxia. Although nonoperative management of such labral lesions may provide symptoms of relief, it may not be enough for the athlete to return to the game. However, surgical treatment in this case provides successful recovery and rapid return to playing baseball play without having to worry about the progression of muscle denervation.
Adolescent* ; Athletes* ; Baseball ; Humans ; Muscle Denervation ; Shoulder

Posterior lumbar interbody fusion can simultaneously achieve spinal stabilization, anterior-column support, and direct neural decompression via a posterior approach. Unilateral transforaminal lumbar interbody fusion (TLIF) has several advantages such as less invasive and less retraction of neural components compared with conventional interbody fusion. But standard posterior spinal fusion with instrumentation requires a moderate amount of paraspinal musculoligamentous dissection. This dissection causes muscle denervation and atrophy that increases risk for failed back syndrome. Therefore, the authors performed a minimally invasive unilateral TLIF with a tubular retractor system combined with pedicle screw fixation to minimize the iatrogenic tissue injury. Although a less invasive unilateral approach was used, the early and longterm outcomes were as good as those on many reported series of posterior interbody fusion. More comfortness during the early postoperative period, small operation scar and less blood loss were the beneficial points compared with other conventional procedures. In the cases of instability of one-motion segment, pedicle screw fixation and TLIF with the tubular retractor system, minimally invasively, can reduce unnecessary trauma to the lumbar supporting structures while still accomplishing sufficient decompression and effective stabilization.
Atrophy ; Cicatrix ; Decompression ; Muscle Denervation ; Postoperative Period ; Spinal Fusion

OBJECTIVETo study the changes of the muscle strength after the selective tibial neurotomy and the relationship between the changes and the quantities of neurotomy, and to discuss the clinical significances.

METHODSTwenty-four normal SD rats were divided into 4 groups with 6 in each. In group A, the left tibia nerve were cut off by 80%. 60% in group B, 40% in group C, 20% in group D, with the right as the control side. After 6 weeks measure the strength of the crural triceps and the weight of them.

RESULTSIn all the groups muscle weight and muscle strength decreased. 88.2% strength decreased on the average in group A, 54.2% in group B, 19.5% in group C, 4.7% in group D.

CONCLUSIONIt will not damage strength of the crural triceps to cut off below 40% tibial nerve in SD rats.

Animals ; Female ; Male ; Muscle Contraction ; physiology ; Muscle Denervation ; Muscle, Skeletal ; innervation ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Tibial Nerve ; surgery

The aim of this study was to delineate the shape of the popliteus muscle and determine the correct motor point site for treating spasticity. A total of 22 legs from 13 fresh Korean cadavers were evaluated. The x-axis was set as a transverse line across the lateral and medial epicondyle of the femur and the y-axis as a vertical line at the midpoint of the medial malleolus of the tibia and lateral malleolus of the fibula. The popliteus muscle is an obtuse triangle in shape. Superior, medial, and inferior angles were 27.2+/-4.3degrees, 114.8+/-19.8degrees, and 38.0+/-18.8degrees respectively. The lengths of the superior, medial, and lateral sides of the triangle were 7.6+/-1.0 cm, 6.2+/-1.0 cm, and 11.9+/-1.5 cm respectively. Nerve branches ran superficially on the periosteum of the tibia and entered the popliteus on its superficial surface. The diverging point of the nerve branch entered the popliteus from the tibial nerve located at the midline of the popliteal fossa and 17% of the leg length above the intercondylar line. Most nerve entry points (83.3%) were within a 2.0x3.0 cm rectangle with the center located at -1.0 cm (-7%) on the x-axis and -3.3 cm (-9%) on the y-axis.
Cadaver ; Denervation ; Femur ; Fibula ; Leg ; Muscle Spasticity ; Muscles ; Periosteum ; Tibia ; Tibial Nerve

Purpose: The ideal neurourophysiologic investigatory technique would objectively and quantitatively evaluate functional status of all parts of the neurologic network involved in obtaining and maintaining penile erection. We assessed electrical activity of the corpus cavernous smooth muscle in normal and neurogenic erectile dysfunction men using SPACE. Material and Methods: A total of 39 normal subjects and 40 neurogenic erectile dysfunction patients underwent single potential analysis of cavernous electricity(SPACE) with a 2-channel EMG amplifier and surface electrodes. The electrical potentials were processed with the cut off frequencies at 0.3 - 32 Hz, a paper speed of 0.5cm/sec, and a range of amplitude of 0.5mV. Results: In 35 of 39 normal subjects(89.7%) and 5 of 10 incomplete suprasacral spinal cord injury patients, similar single potentials of uniform shape were recorded. In patients with peripheral autonomic denervation, irregular shape potentials with higher frequency and lower amplitude were found. In 3 of 5 patients with long standing diabetes(over 15 years), SPACE shows electrical silence. Conclusion: These results suggest that SPACE test is a useful noninvasive and reproducible method for evaluating cavernous innervation in erectile dysfunction. Furthermore, the single potential means intact cavernous innervation.
Autonomic Denervation ; Electrodes ; Erectile Dysfunction ; Humans ; Male ; Muscle, Smooth* ; Penile Erection ; Spinal Cord Injuries

PURPOSE: To determine the time of magnetic resonance(MR) signal intensity changes in denervated skeletal muscle and to compare MR imaging with electromyography(EMG) in the evaluation of peripheral nerve injury. MATERIALS AND METHODS: We evaluated MR imagings of denervated muscles after experimental transection of the sciatic nerve in five rabbits using 1.0T MR unit. MR imaging and EMG were performed 3 days and 1, 2 and 3 weeks after denervation. T1-weighted images(T1-WI), T2-WI and Short Tau Inversion Recovery(STIR) images were obtained. The signal intensity (SI) of muscles in the denervated and normal sides were visually and quantitatively compared. After measuring the SI of the normal and abnormal areas, the time of SI change was determined when there was significant difference (P<0.05) of SI between the normal and denervated sides. RESULTS: On STIR images, two of the five rabbits showed significant SI changes at the third day(P<0.05) and all showed significant changes(P<0.05)at the first week. On T2-WI, one rabbit showed significant SI changes at the third day, and all showed significant SI changes at the first week. On T1-WI, significant SI changes were seen in one rabbit at the second week and in one at the third. One week after denervation, all showed denervation potential on EMG. CONCLUSION: This study suggests that MR imaging using STIR images is a useful method in the evaluation of denervated muscle, and that MR signal changes of denervated muscle may precede EMG changes after denervation. To localize and to determine the severity of the peripheral nerve injury, future analysis of the distribution of abnormal MR SI in denervated muscles would be helpful.
Denervation ; Magnetic Resonance Imaging* ; Muscle, Skeletal* ; Muscles ; Peripheral Nerve Injuries ; Rabbits* ; Sciatic Nerve

PURPOSE: We investigated whether periurethral injections of muscle- derived stem cells (MDSC) and chitosan/hydroapatite after denervation of rat's pudendal nerve could increase the leak point pressure over a long time period in a rat model of urinary incontinence. MATERIALS AND METHODS: Muscle-derived stem cells isolated from the gastrocnemius muscle of normal female rats were purified to obtain a myogenic population by using the preplate technique. The N group was the normal female rats, the D Group was the pudendal nerve transected group and the M Group was the MDSC/chitosan/hydroapatite composite gel injected group after pudendal nerve transection. The MDSC/chitosan/hydroapatite composite gel was injected into the proximal periurethral area. At 2 and 4 weeks, visually identified leak point pressure measurement was done with using the vertical tilt/intravesical pressure clamp model of urinary incontinence. The rats were then sacrificed and the periurethral tissues harvested for histological examination. RESULTS: The leak point pressure was significantly lower in the D group at each time compared with the N group, and the leak point pressure in the N and M groups were significantly higher than those in the D group at both 2 and 4 weeks. The persistence of MDSC over the period of study was verified by histological examination. CONCLUSIONS: MDSC/chitosan/hydroapatite injection into the denervated external urethral sphincter in female rats increased the leak point pressure at 2 and 4 weeks. This MDSC/chitosan/hydroapatite composite gel can be an alternative injection method for treating urinary incontinence in the future.
Animals ; Denervation ; Female ; Humans ; Models, Animal* ; Muscle, Skeletal ; Pudendal Nerve ; Rats* ; Stem Cells ; Urethra ; Urinary Incontinence*

PURPOSE: In this study, we tested whether injections of muscle-derived stem cells and alginate(Alg)/polycaprolactone(PCL) after denervation of the pudendal nerve could increase the leak point pressure(LPP) and closing pressure(CP) over the long term in a rat model of urinary incontinence. MATERIALS AND METHODS: Muscle derived stem cells(MDSC) were isolated from the gastrocnemius muscle of normal female rats, and these cells were purified for creating a myogenic population by the preplate technique. In the denervated(D) group, the pudendal nerve was transected bilaterally via a dorsal incision in order to denervate the external urethral sphincter. The denervated external urethral sphincter was injected with Alg/PCL(AP group), or MDSC/Alg/PCL(M group) into the proximal urethra after pudendal nerve transection. At 1 and 3 months, the LPP and CP measurements were visually identified by using the vertical tilt/intravesical pressure clamp model of stress urinary incontinence. The rats were then sacrificed and their urethras were harvested for histology. RESULTS: Both the LPP and CP were significantly lower in the denervated group at each time compared with the normal(N group), AP and M groups, and both the LPP and CP in the N, AP and M groups were significantly higher than those in the D group at both 1 and 3 months. The persistence of MDSC over the period of the study was verified by histology. Thus, pudendal nerve denervation led to a progressive decline in the LPP and CP that was evident at 1 month and this persisted to 3 months, and injection of MDSC/Alg/PCL into the denervated rats led to a long term increase in the LPP and CP. CONCLUSIONS: The N, AP and M groups all had significantly higher LPPs than the D group, and MDSC/Alg/PCL injection into the denervated external urethral sphincter in female rats increased the LPP and CP in both the short and long term. We also observed a long term bulking effect of MDSC/Alg/PCL injection in the stress incontinence animal model.
Animals ; Denervation ; Female ; Humans ; Models, Animal ; Muscle, Skeletal ; Pudendal Nerve ; Rats* ; Stem Cells ; Urethra* ; Urinary Incontinence

BACKGROUND: The purpose of this study was to investigate whether the effects of mivacurium on muscular relaxation were similar by the duration of more than 2 weeks after the injury of lower motor neurons in rabbits. METHODS: The animals were divided into five groups. The control group was without lower motor neuron injury. In the experimental groups, the lower motor neuron injury was made by denervating with 75 - 80% lesion on the common peroneal nerve to the right anterior tibialis muscle. The experimental groups were subdivided as 1, 2, 3 and 4 week groups (referred to ad the 1 wk, 2, 3 and 4 wks group) according to the durations of the denervation of common peroneal nerve, respectively. The dose-response relationship of mivacurium on the muscle twitches induced by TOF (train of four) stimulation (supramaximal stimulus of 0.2 ms duration, square-wave pulses, 2 Hz rate, repeated every 10 seconds) was studied by calculating ED50 and ED95 in the anterior tibialis muscles and compared between all groups. After recording the muscle twitches, microscopic findings were observed. RESULTS: The effective dose for 95% twitch depression (ED95) of mivacurium at 1week after denervation was significantly higher than that of the control group (P <0.05), but the ED95 of 2, 3 and 4wks groups were not significantly different from that of the control group. However, the ED95 of 3 and 4wks group were inclined to be lower than that of the control and significantly lower than 1wk group (P < 0.05). There was no significant difference in the effective dose for 50% twitch depression (ED50) of mivacurium in all groups. The size of the anterior tibialis muscle was significantly decreased at 4weeks after the lower motor neuron injury (P <0.05), but the number of its sarcoplasmic nuclei was increased, according to the duration after the denervation. CONCLUSIONS: Our results therefore suggest that neuromuscular response of denervated anterior tibial muscle was resistant to intravenous mivacurium in early periods of 1 or 2 weeks but sensitive 4 weeks after the lower motor neuron injury.
Animals ; Denervation ; Depression ; Motor Neurons* ; Muscle, Skeletal ; Muscles ; Peroneal Nerve ; Rabbits* ; Relaxation*

Congenital unilateral lower lip paralysis (CULLP) is a rare condition characterized by inversion and absent depressive movement of the affected lower lip while moving the mouth, which is recognized when the infant cries. CULLP is a variation of facial paralysis caused by abnormal development of marginal mandibular nerve, hypoplasia of the depressor labii inferioris muscle or depressor anguli oris muscle. This report introduces two cases of congenital unilateral lower lip palsy, presenting a balancing technique involving the resection of the depressor labii inferioris on the non-affected side.
Facial Paralysis ; Humans ; Infant ; Lip* ; Mandibular Nerve ; Mouth ; Muscle Denervation ; Paralysis*