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Radiation-induced lumbar plexopathy (RILP) or radiation-induced lumbosacral plexopathy (RILSP) is nerve damage in the pelvis and lower spine area caused by therapeutic radiation treatments. RILP is a rare side effect of external beam radiation therapy [ 1 ] [ 2 ] [ 3 ] and both interstitial and intracavity brachytherapy radiation implants.
Sacral nerve stimulation, also termed sacral neuromodulation, is a type of medical electrical stimulation therapy. It typically involves the implantation of a programmable stimulator subcutaneously , which delivers low amplitude electrical stimulation via a lead to the sacral nerve , usually accessed via the S3 foramen .
The lower bowel may be treated directly with radiation (treatment of rectal or anal cancer) or be exposed by radiation therapy to other pelvic structures (prostate, bladder, female genital tract). Typical symptoms are soreness, diarrhoea, and nausea. Nutritional interventions may be able to help with diarrhoea associated with radiotherapy. [25]
The success rate of the paradigm of lumbar MRI and disk resection for treatment of sciatica is therefore about 15%(Filler 2005). Neurography has been applied increasingly to evaluate the distal nerve roots, lumbo-sacral plexus and proximal sciatic nerve in the pelvis and thigh to find other causes of sciatica.
Magnetic resonance myelography (MR myelography or MRI myelography) is a noninvasive medical imaging technique that can provide anatomic information about the subarachnoid space. It is a type of MRI examination that uses a contrast medium and magnetic resonance imaging scanner to detect pathology of the spinal cord , including the location of a ...
The treatment protocol requires once-a-week treatments for 12 weeks, 30 minutes per session. Many patients begin to see improvements by the 6th treatment. Patients who respond to treatment may require occasional treatments (about once every three weeks or as needed [11]) to sustain improvements. PTNS is a low-risk procedure.