Evidence map›Paper›PMID 32970169›Full record

ArticleSurgical and radiologic anatomy : SRA2021

Does the L5 spinal nerve move? Anatomical evaluation with implications for postoperative L5 nerve palsy.

Basem Ishak, Shogo Kikuta, Tyler Scullen, Joe Iwanaga, Daniel J Denis, Christopher M Maulucci, Aaron S Dumont, R Shane Tubbs

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In one paragraph

Article in Surgical and radiologic anatomy : SRA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 4 countries.

Basem IshakDepartment of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Shogo KikutaDental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Tyler ScullenTulane University and Ochsner Clinic Neurosurgery Program, Tulane University School of Medicine, New Orleans, LA, USA.
Joe IwanagaDental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan. iwanagajoeca@gmail.com.ORCID http://orcid.org/0000-0002-8502-7952
Daniel J DenisDepartment of Neurosurgery, Ochsner Health System, New Orleans, LA, USA.
Christopher M MaulucciTulane University and Ochsner Clinic Neurosurgery Program, Tulane University School of Medicine, New Orleans, LA, USA.
Aaron S DumontDepartment of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.
R Shane TubbsDepartment of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.
Tulane University · USHeidelberg University · DEKurume University · JPKurume University Medical Center · JPOchsner Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWhile palsy of the L5 nerve root due to stretch injury is a known complication in complex lumbosacral spine surgery, the underlying pathophysiology remains unclear. The goal of this cadaveric study was to quantify movement of the L5 nerve root during flexion/extension of the hip and lower lumbar spine.

methodsFive fresh-frozen human cadavers were dissected on both sides to expose the lumbar vertebral bodies and the L5 nerve roots. Movement of the L5 nerve root was tested during flexion and extension of the hip and lower lumbar spine. Four steps were undertaken to characterize these movements: (1) removal of the bilateral psoas muscles, (2) removal of the lumbar vertebral bodies including the transforaminal ligaments from L3 to L5, (3) opening and removing the dura mater laterally to visualize the rootlets, and (4) removal of remaining soft tissue surrounding the L5 nerve root. Two metal bars were inserted into the sacral body at the level of S1 as fixed landmarks. The tips of these bars were connected to make a line for the ruler that was used to measure movement of the L5 nerve roots. Movement was regarded as measurable when there was an L5 nerve excursion of at least 1 mm.

resultsThe mean age at death was 86.6 years (range 68-89 years). None of the four steps revealed any measurable movement after flexion/extension of the hip and lower lumbar spine on either side (< 1 mm). Flexion of the hip and lower lumbar spine revealed lax L5 nerve roots. Extension of the hip and lower lumbar spine showed taut ones.

conclusionSignificant movement or displacement of the L5 nerve root could not be quantified in this study. No mechanical cause for L5 nerve palsy could be identified so the etiology of the condition remains unclear.

Indexed as

AgedAged, 80 and overCadaverFemaleHipHumansLumbar VertebraeLumbosacral RegionMaleMovementOrthopedic ProceduresParalysisPostoperative ComplicationsPsoas MusclesSpinal Nerve RootsAnatomical studyL5 nerve palsyNerve movementNerve strainStretch injury

Identifiers

PMID32970169
OpenAlexW3089279328

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.