Bilateral variant locations of the musculocutaneous nerve during ultrasound-guided bilateral axillary brachial plexus block: A case report

Ultrasound-guided peripheral nerve block has several advantages over traditional techniques for nerve localization. One is a reduction of local anesthetic dose required for successful nerve block, which might allow bilateral brachial plexus block to be performed without risk of local anesthetic toxicity. Another advantage is the ability to detect anatomical variations in nerve and vascular anatomy. We report the case of a patient with unilateral anatomical variations of the musculocutaneous nerve found in ultrasound-guided bilateral axillary brachial plexus block.

Clinical and Radiological Comparison of Semirigid (WavefleX) and Rigid System for the Lumbar Spine

OBJECTIVE: Spinal fusion operation is an effective treatment in the spinal pathology, but it could change the physiological distribution of load at the instrumented and adjacent segments. This retrospective study compared the radiological and clinical outcomes of patients undergoing lumbar fusion with semirigid rods versus rigid rods system. METHODS: Using transpedicular fixation and posterior lumbar interbody fusion at the level of L4/L5, 20 patients were treated with semirigid rods (WavefleX, SR group), and 20 patients with rigid rods (titanium, RR group). Clinical and radiological outcomes were evaluated, including visual analog score for lower back pain and leg pain, Prolo functional and economic scores, statues of implanted instruments, fusion rate, and complications during 24-month follow-up. RESULTS: Clinical scores were significantly improved until postoperative 24-month follow-up as compared with preoperative scores in both groups (p<0.05), with similar levels of improvement observed at the same time points postoperatively between the 2 groups. Prolo economic scores were significantly improved in SR group compared to RR until 12 months, but this improvement became similar after 18 months. The overall fusion rate was 94.1% until the 24-month follow-up for both groups. No significant complication was observed in both groups. CONCLUSION: The results of the present study indicate that semirigid rods system with posterior lumbar interbody fusion showed similar clinical and radiological result with rigid rods system until 2 years after instrumentation. The WavefleX rods system, as a semirigid rods with unique characteristics, may be an effective alternative treatment for patients in lumbar fusion.