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Results for “LUMBOSACRAL REGION”

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At least 469 records · Page 26Linked to original sources

PubMed2003

Spinal cord compression: a review of 70 pediatric patients.

The authors report their experience with 70 pediatric patients with spinal cord compression (SCC) due to malignancies identified among 898 patients with solid tumors. An extradural tumor was the most frequent cause of SCC (71%); 54% of these were soft tissue sarcomas and neuroblastoma. Most intradural tumors (70%) were outside the spinal cord, 9/12 being metastatic medulloblastomas. The SCC localized mainly to the dorsal and lumbosacral regions (42% each). Pain was the most common symptom (94%). MRI proved diagnostic in all cases in which it was used, while myelography was diagnostic in 85% of 26 patients. CT scan demonstrated the lesion in 83% of the patients. Laminectomy was provided for patients with paraplegia of less than 96 h evolution; isolated recurrence of the main tumor; a primary spinal cord tumor; progression of neurologic symptoms after chemotherapy/radiotherapy; chemotherapy and radiotherapy-resistant tumor (when known); resection of a paraspinal tumor. Surgery was avoided when prognosis of primary disease was poor or risks exceeded possible benefits. Twelve/twenty-one (57%) patients with paraplegia were able to walk after laminectomy only, while 14% (2/14) improved after chemotherapy and radiotherapy. Survival rates were 38% for the former and 36% for the latter. Overall survival was related to the original malignancy. All patients (12) admitted without paraplegia and submitted to laminectomy were able to walk, and of these, 6 presented a primary spinal cord tumor. The remaining had paraspinal tumors that extended to the spinal canal. Almost 87% (20/23) of the patients without paraplegia who submitted to medical treatment were able to walk, while only one progressed to paraplegia. Patients with SCC may entertain radio- and chemotherapy when harboring tumors responding to such therapies and present no evidence of neurologic damage progression. The latter manifestation is a strong indication for laminectomy without delay.

Adolescent↗

PubMed2004

[Total endoprosthesis replacement after hip joint arthrodesis].

PURPOSE OF THE STUDY: To evaluate mid-term results of conversion of arthrodesis to total hip replacement in terms of X-ray findings and benefits for the patient. MATERIAL: Ten patients who had undergone hip joint arthrodesis were clinically examined and X-rayed and the findings evaluated. The most common indications for arthrodesis were posttraumatic lesions or the sequelae of a dysplastic hip joint, Perthes disease and inflammatory hip arthritis. The average age was 24.6 years (range, 15-37) at the first operation (arthrodesis) and 42.5 years (range, 30-61) at the second operation (hip arthroplasty). The average follow-up was 9.3 years (range, 1-16). Patients with true ankylosis of the hip joint were not included. METHODS: The patients were clinically examined for the range of motion, which was evaluated by Harris hip scores and X-ray findings. RESULTS: All eight patients who underwent total hip replacement due to persistent pain in the lumbosacral region experienced pain relief or its absence. This also applied to the patients whose X-ray films showed signs of spondylarthritis. The Harris hip scores showed that six patients were able to walk to longer distances without any support. No radiographic evidence of acetabular component loosening was found. One patient had to undergo reimplantation of the femoral component because of aseptic loosening. In the early postoperative period, one dislocation of the prosthesis and one sciatic nerve injury resulting in transient paresis of the peroneal nerve were recorded. None of the complications required repeat surgery. All patients reported that they would undergo the procedure again despite an increased risk associated with this procedure. DISCUSSION: Our results are in agreement with similar findings in this field. We did not find an increase in failed hip arthroplasty in older patients. The X-ray findings were very satisfactory, particularly those concerning the acetabular component. Patients who had true ankylosis of the hip joint were not included in the study. The average range of motion achieved in our patients corresponds to that reported in the literature. CONCLUSIONS: Conversion of hip arthrodesis to total hip replacement is not a frequent surgical procedure. It is associated with a higher degree of risk because of changed anatomy due to previous surgical interventions in that region. Motion restoration in the hip joint results in reducing low back pain and, consequently, improving the quality of life. All evaluated patients would be willing to undergo the operation again.

Adolescent↗

PubMed2005

Comparison of the effects on spinal reflexes of acetylsalicylate and metamizol in spinalized and normal rats.

The effects of nonsteroidal antiinflammatory drugs, acetylsalicylate and metamizol, on spinal monosynaptic reflexes were investigated in spinalized and normal rats. Adult rats (n=36) weighing 150-200 g were anesthetized with ketamine and artificially ventilated. Half of rats were spinalized at C1 level. A laminectomy was performed in the lumbosacral region. Following electrical stimulation of the sciatic nerve by single pulses, reflex potentials were recorded from the ipsilateral L5 ventral root. Acetylsalicylate was administered orally (100 mg/kg for both spinalized and normal rats). Metamizol was administered intramuscularly (15 mg/kg for both spinalized and normal rats). These drug administrations significantly decreased the amplitude of reflex response in all groups (p < 0.05). These data verify that observed inhibition by acetylsalicylicate and metamizol may be at the level of spinal cord. Also we suggested that the cyclooxygenase products of arachidonic acid may play an important role in regulating the reflex potential.

Animals↗

PubMedDate not supplied

[Degenerative disease of the lumbar spine. Clinical and magnetic resonance imaging correlation].

BACKGROUND: Low back pain often affects the economically active population with repercussions in world productivity. MRI defines the diagnosis easily with high specificity, allowing the most adequate treatment to be initiated. We undertook this study to confirm the diagnostic sensitivity and specificity of MRI in the evaluation of degenerative lumbosacral disease with facet joint participation. METHODS: In a 6-month period we studied 358 patients with low back pain and/or sciatica due to degenerative disorders. We performed a basic evaluation on the clinical characteristics of pain. Plain sequences (T1 and T2) were used on axial, sagittal and coronal planes with MR equipment (0.5 T), evaluating the degenerative modifications of the lumbosacral region. RESULTS: Discal degeneration associated with multidirectional bulging of annulus and extrusion and protrusion of discal material affected mostly L4-L5 and L5-S1 levels. The same levels showed most degenerative changes on facet joints. The most relevant result in our study was articular facet joint disease present in all cases regardless of the association with intervertebral osteochondrosis, discal hernia and spinal stenosis. CONCLUSIONS: Diagnostic value of MRI in the study of low back pain offers a reliable evaluation with high sensitivity and specificity, in order to make appropriate therapeutic decisions.

Adolescent↗

PubMed2006

Computed tomography in detecting bone metastases of breast carcinoma. Is it better than plain x-ray?

OBJECTIVE: To compare 5mm slice computerized tomography (CT) and conventional x-ray (XR) in the detection of bone metastases in breast carcinoma patients. METHODS: Ninety-eight female breast cancer patients treated in Ankara Oncology Hospital, Ankara, Turkey between September 1997 and March 2002 were assigned into 3 groups with respect to their Tc bone scan (Sc) results. Group 1 included patients with overt bone metastases, group 2 included patients with suspicious of metastases and group 3 were those patients with normal Sc results with back pain complaint. All patients underwent XR, and 5mm contiguous slice CT imaging for the related metastatic sites. For the third group, lumbosacral region was examined. RESULTS: A total 33 bone metastases have been diagnosed out of 98 patients. The Sc result showed 26/33 metastatic cases, XR 19/33 and CT 22/33 cases. There were no false positive results for CT and XR. Results of CT have 11 and XR has 14 false negatives out of 33 metastases. For XR the calculated sensitivity was 65.6, specificity was 100, diagnostic accuracy was 88.7, whereas for CT, sensitivity was 71.8, specificity was 100 and diagnostic accuracy was 90.8. When CT and XR were compared to detect bone metastases, results were not statistically significant (p>0.05). CONCLUSION: Our results suggest that 5mm slice CT is not superior than XR to detect metastatic bone lesions. Larger series comparing different slice thickness of CT are needed to clarify the issue.

Adult↗

PubMed2006

[Thoracic meningocele].

Herniation of the meninges through a defect of the spinal canal is a spinal meningocele, and is usually located dorsally in the lumbosacral region. Meningoceles are usually part of a complex developmental disorder, or of a systemic disease, or it can be iatrogenic, as well. We report a very rare case of a true anterior thoracic meningocele.

Diagnosis, Differential↗

PubMedDate not supplied

Diagnosis and treatment of intraspinal lipomas.

In this article a 32-case series of intraspinal lipoma localized to the lumbosacral region is presented. All of the patients underwent surgery. Recent reports in the literature indicate that although these lesions show advanced and progressive neurological deficits, very good results can be achieved with surgical treatment. The advantages of computed tomography in diagnosis and the importance of early surgical intervention and postoperative rehabilitation are emphasized.

Adolescent↗

PubMed1990

Tuberous sclerosis: report of a case with fibromatosis of the facial soft tissues.

Tuberous Sclerosis (TS) is a dominantly inherited disorder which is characterised by a triad of mental deficiency, epilepsy and angiofibromas of the face. Sub- and periungual fibromas, shagreen patches usually found in the lumbosacral region and hypopigmented skin lesions are less often seen. Paraventricular calcifications, skeletal disorders and rarely, ophthalmic tumours are also described. Oral manifestations include whitish confluent nodules on the mucosa, enamel hypoplasia, mandibular cysts, and oral fibromas. A case of fibromatosis of the subcutaneous tissue overlying the angle of the mandible is described together with TS. To the best knowledge of the authors, this is the first such case reported in the literature.

Child, Preschool↗

PubMedDate not supplied

A comparison of default and reduced bandwidth MR imaging of the spine at 1.5 T.

The value of a reduced bandwidth MR imaging technique was tested prospectively in 51 spinal MR examinations by using default (16 kHz) bandwidth, 2000/30, 90 (TR/TEs) and 600/30, and reduced (8 kHz) bandwidth, 2000/48, 92 and 600/30, techniques at 1.5 T. Bandwidth reduction was used to maintain the signal-to-noise ratio for a reduced scan time. Concerns have been raised as to the effect of bandwidth reduction at high field, since a savings in time or an increased signal-to-noise ratio occur at the expense of increased chemical shift misregistration artifact. However, when appreciable, the chemical shift-related artifact in the spine was typically located in the frequency-encoding direction at the vertebral body/disk space interface or the dural sac/epidural fat interface in the lower lumbosacral region and was easily distinguished from pathologic lesions. There were no missed diagnoses with the reduced bandwidth technique. This study suggests that chemical shift-related artifact will rarely be confused with pathology by an experienced reader and suggests a clinical role for the bandwidth technique to decrease scanning time in uncooperative patients or to allow acquisition of additional imaging planes in a reasonable time.

Adolescent↗

PubMed1990

[Microtraumatic pathology of the lumbar isthmus: isthmic lysis or spondylolysis].

The authors report the study of a series of 23 partial isthmic lyses which occurred in a young population (15 cases) and in an adult one (8 cases) between 1983 and 1988, in the form of persistent lumbosacral pains. The initial radiological signs, the key to an early diagnosis, are defined: cortical notches more often regarding the lower cortex than the upper one, incomplete fissures reaching the two cortical poles, gradual narrowing of the isthmus. The value of standard radiography is underlined, with the oblique incidences close to the profile regularly ensuring the diagnosis, with the exception of 4 cases out of 23 for which tomography was required. As regards the evolution, the value of the diagnosis of the initial lesions is recalled, giving the hope of a restoration of the posterior inter-articular fractures by a rigid setting (4 months on average). This ability to reconstruct the lumbar isthmus is observed in the young subjects (10 out of 13 immobilizations) but also in the adult subjects (3 reconstructions for 5 immobilizations carried out). These results enable the early detection of prelytic states, in order to administer an suitable treatment resting on the rigid setting of the lumbosacral region, re-education and the control of the risk factors.

Adolescent↗

PubMed1990

[The results of a clinical trial of the preparation Ossopan].

The preparation Ossopan was used for period of one month in 20 pregnant women at 28 to 40 weeks' gestation with pain syndrome in the long bones, lumbosacral region and disturbed dental status. Its effect was studied on second group of 13 women with established clinically and roentgenologically climacteric osteoporosis, using a therapeutic course of 1 pill daily for a period of 6 months. A considerable clinical improvement of pain syndrome and dental status was found in the end of the treatment. The positive therapeutic effect, easy way of administration, its good tolerance and lack of side make it convenient for treatment of disturbances in calcium-phosphorus balance.

Adult↗

PubMed1990

Retroperitoneal fibrosis.

Retroperitoneal fibrosis, an uncommon and ill-defined condition, has a variety of causes and presenting features. The fibrotic process often produces ureteral obstruction and compression of surrounding structures. Pain in the flank, lower abdomen or lumbosacral region is the most common presenting symptom. Certain drugs, neoplasms, retroperitoneal injury or infections may all initiate the fibrotic process. This article describes a case of retroperitoneal fibrosis in a 34-year-old man who had been receiving a beta-adrenergic blocking agent.

Adult↗

PubMed1990

[Treatment of neuromyelopathy after repair of myelomeningocele or meningocele].

Forty-two cases of neuromyelopathy after lower thoracic lumbosacral myelomeningocele or meningocele repairment were reported. The repaired ages were from newborn to 6 years old. Subsequently progressive paralysis of lower extremities with incontinence of bowel and urination were seen after the primary operation. It may be due to "tethered spinal cord syndrome" or postoperative adhesion. Removal of the scar of adhesions over the lower thoracic and lumbosacral region and neurolysis were performed. Following 3-30 months after operation we found out that recovery of bowel function in 38 cases (90.5%). Active urination was recovered in 13 cases (31%) and improved in 22 cases (52.4%). Motor dysfunction and paresthesis of the lower extremities were alleviated in 19 (73.1%) of the 27 cases. No case revealed aggravation of symptom due to operative procedure.

Adolescent↗

PubMed1990

CT and MRI in spinal meningeal cyst. Report of a case.

A case of meningeal cyst of the spinal canal in the lumbosacral region is described. A CT scan showed a soft tissue mass associated with bone erosion. Myelography and computerised tomographic myelography revealed a cyst filling with contrast and thus CSF containing. The diagnosis of meningeal cyst was confirmed in a non-invasive way by MRI showing a mass with the same signal intensities as CSF on both T1 and T2 weighted images. Final characterisation of meningeal cysts in one of the three categories comprising spinal extradural meningeal cyst without spinal nerve root fibers (type I), spinal extradural meningeal cyst with spinal nerve root fibers (type II) and intradural meningeal cyst (type III) is impossible without operative inspection and histological examination.

Aged↗

PubMed1989

[Multiple spinal neurinomas without von Recklinghausen's disease: report of three cases].

Multiple spinal tumors are relatively rare and account for from only 1.2 to 9.5% of all spinal tumors. Half of the multiple spinal tumors are accompanied with von Recklinghausen's disease. Since March 1983, we have encountered 31 spinal tumors including 11 neurinomas, three of which were multiple and showed no manifestations of von Recklinghausen's disease. The incidence of multiple spinal tumors was 9.7% in our series. Altogether, 40 cases of multiple spinal neurinomas without von Recklinghausen's disease have been reported including our three cases. According to those 40 cases, much neurinomas occur 5 times more frequently in men than in women, and they are found predominantly in the lumbosacral region. In the present paper, we describe three cases of multiple spinal neurinomas, and compare the results of several neuroradiological examinations. Myelography was the most reliable method to determine whether or not the tumors were multiple. However, in cases where myelography was completely blocked out, other neuroradiological methods such as metrizamide-CT scan or MRI with Gd-DTPA intravenous injection were able to bring us information concerning multiplicity.

Adult↗

PubMedDate not supplied

[Remuscularization of the bladder in traumatic spinal cord disease].

A topographic anatomical study of 80 cadavers has suggested a new method of surgical treatment for paralytic neurogenic bladder developing as a result of an injury of lumbosacral regions of the spine or horse-tail roots. The method consists in the remuscularization of neurogenic bladder by grafts, tailored from the outer parts of abdominal musculus rectus with supplying lower epigastric vessels. Twenty-one operations were performed using this method. Controlled micturition was recovered within 3 or 4 weeks. The volume of residual urine never exceeded 50 ml. Pyelonephritic attacks ceased.

Abdominal Muscles↗

PubMedDate not supplied

[Functional changes in the pituitary-adrenal system during the action of electroacupuncture on patients with spinal osteochondrosis].

A session of low-frequency electroacupuncture (EAP) of the nerve points of the cervicobrachial or lumbosacral regions was performed in 61 patients with vertebral osteochondrosis. An EAP therapeutic effect, analgetic one in particular, was found to depend on cortisol and aldosterone blood levels: reduced levels of the hormones related to EAP procedure appeared associated with a positive therapeutic response.

Acupuncture Points↗

PubMed1989

[Radiological study of lumbosacral nerve root sheath cyst (analysis of 65 cases)].

65 cases of nerve root sheath cyst of lumbosacral region were found out of 544 cases of myelography, 43 were confirmed by operation. The main radiologic features were: round or oval in shape in 28 cases; cylindrical or fusiform in 14; and mixed form in 13. In 10 cases, the contrast medium was seen to extend in an irregular pattern along nerve root sheath.

Adult↗