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PubMedDate not supplied

Lumbosacral tumors with a retroperitoneal development.

Neoplasms are relatively rare in the lumbosacral region. The present study presents two cases with tumors in the lumbosacral region, a chordoma and a tumor with multinucleated giant cells which further showed a presacral development. Some common aspects of the clinical and radiologic symptomatology were evidenced as well as the specific characteristics of each separate tumor in our cases. The diagnosis was possible due to the modern radiologic equipment.

Adult↗

PubMed1981

Movements, lumbar and temporomandibular pain and psychopathology.

157 males and females divided into four psychodiagnostic groups have been examined according to a specially defined physiotherapeutic (ad modum Sundsvold). In this paper, results from the evaluation of passive and active movements in five body significant differences concerning inhibited movements between the four groups were found, the psychotic group being most inhibited followed by the ego-week neurotic group, the substance-abusing group and the healthy control group. With regard to the slack movements, significant differences were found in the two extremity regions. The substance-abusing group had the most slack movements, next came the ego-weak neurotic group, the psychotic group and lastly the control group. Men were more inhibited than women in three regions, mostly in the lumbosacral region. This finding is discussed in relationship to the high frequency of lumbar disc herniation in men. Women were more significantly inhibited in the temporomandibular region, a finding which may explain why mostly women are suffering from the myofacial pain syndrome.

Adolescent↗

PubMed1997

Pattern of malformations in the axial skeleton in human trisomy 13 fetuses.

The purpose of this study was to analyse the development of the axial skeleton in human trisomy 13 fetuses and to define which fields in the axial skeleton are affected in this condition. We investigated nine human fetuses with trisomy 13 and gestational ages of 14-19 weeks. Whole body radiographs and radiographs of midsagittal tissue blocks of the cranial base and the spine were studied. In the youngest fetus, 14 w GA, no malformations were observed. In eight fetuses, 17-19 weeks GA, malformations occurred in the lumbosacral spine. In four fetuses additional malformations were observed in the thoracic spine. The study showed that there was a correspondence between the extent of malformation in the lumbosacral spine and the thoracic spine. When mild malformation occurred in the lumbosacral region, no malformation was observed in the thoracic region, whereas malformation was observed in the thoracic region when there was extensive malformation in the lumbosacral region. Malformations did not occur in the cervical spine or the basilar part of the occipital bone, but the postsphenoidal part of the sphenoid bone was small and irregular in the six cases where it could be examined. In seven fetuses there was malformation or agenesis of the nasal bone. This pattern of axial skeletal malformations in trisomy 13 fetuses was not described previously. Comparisons are made with previous studies of the fetal axial skeleton in trisomy 18 and trisomy 21, where the pattern of malformations was different. We reiterate our recommendation that axial skeletal radiography should be part of the postmortem examination of fetuses with suspected or verified chromosome abnormalities.

Abnormalities, Multiple↗

PubMed1998

Stress fractures of the vertebral lamina and pelvis in Thoroughbred racehorses.

Thirty-six Thoroughbred racehorses that died at California racetracks between October 1993 and July 1994 were evaluated for stress fractures in the caudal portion of the thoracic and lumbosacral regions of the spine and the pelvis. The lumbosacral spine and pelvis were collected, debrided of soft tissues and examined visually for the presence of an incomplete fracture line and focal periosteal proliferation, characteristic of a stress fracture. Sixty-one per cent of specimens had evidence of stress fracture in the caudal portion of the thoracic and lumbosacral regions of the spine and the pelvis. Vertebral lamina stress fractures were found in 50% of specimens and were positively associated with the severity of dorsal spinous process impingement and overall severity of articular process degenerative changes. Pelvic stress fractures affected 28 % of specimens and occurred more frequently in older horses. Pelvic stress fractures were positively associated with the severity of lumbar transverse process impingement and several ilial articular surface degenerative changes. A high prevalence of vertebral and pelvic stress fractures was noted in this sample of Thoroughbred racehorses that died because of unrelated injuries. Vertebral and pelvic stress fractures need to be considered in the clinical evaluation of horses with back problems or hindlimb lameness. Undiagnosed stress fractures of the vertebrae or pelvis could be a significant cause of poor performance and lameness in Thoroughbred racehorses.

Age Factors↗

PubMed2004

Primary lumbosacral Wilms tumor associated with diastematomyelia and occult spinal dysraphism. A report of a rare case and a short review of literature.

BACKGROUND: The occurrence of an extrarenal Wilms tumor in the lumbosacral region is an extremely uncommon condition. CASE REPORT: We report a case of Wilms tumor in the lumbosacral region that was associated with diastematomyelia and occult spina bifida. An 18-month-old girl presented with a swelling over the lower back with a tuft of hair on it, which she had had since birth. Imaging of the spine revealed spina bifida, bony diastematomyelia, and tethered cord. Excision of the bony spur and detethering of the cord was done. After a year, she had recurrence of swelling at the same site, weakness of both lower limbs, and incontinence of bladder and bowel. Excision of the mass and bony spur and detethering of the spinal cord were done. Histopathological examination showed features of a Wilms tumor.

Female↗

PubMed2006

The impact of body site, topical melatonin and brushing on hair regrowth after clipping normal Siberian Husky dogs.

The aims of this study were to determine the impact of body site, vigorous brushing and topical melatonin treatment on hair regrowth after clipping normal dogs. Siberian Husky dogs were randomly assigned to three groups of eight dogs each. All dogs had the lumbosacral region and both lateral thighs clipped. The left thigh and lumbosacral area received no treatment and were compared in all 24 dogs. Eight dogs had the right thigh treated with 0.1% melatonin twice daily for 2 months, and hair regrowth was compared with the left thigh. Eight dogs had the right thigh brushed twice daily for 2 months, and hair regrowth was compared with the left thigh. Eight dogs had neither thigh treated. Hairs were plucked before and 2 months postclipping, and the proportion of hair growth from the original length was calculated and compared as described above. Biopsy samples were collected before and after treatment to determine if brushing induced dermal inflammation and melatonin increased the proportion of anagen follicles. Proportionally, left thigh hairs were significantly longer compared to lumbosacral hairs 2 months postclipping. No significant differences in hair regrowth were noted between the nontreated thigh and the thigh treated with melatonin or brushed. No significant difference in dermal inflammation was noted before and after brushing. No significant differences were observed in the proportion of anagen follicles before and after topical melatonin treatment. Our results showed that the hairs in the lumbosacral region were proportionally shorter than lateral thigh hairs 2 months postclipping. Moreover, topical melatonin and brushing had no impact on hair regrowth after clipping normal dogs.

Adjuvants, Immunologic↗

PubMed2001

Diastematomyelia associated with ectopic dysplastic renal tissue--report of a rare case.

BACKGROUND: Presence of heterotopic dysplastic renal tissue in the lumbosacral region is an extremely uncommon condition. CASE REPORT: We report the first case of diastematomyelia associated with ectopic renal tissue. A 10-month-old male child presented with lipomeningomyelocele associated with spina bifida in the lumbosacral region, and the lipoma was excised. Imaging of the spine at 5 years of age showed spina bifida, bony diastematomyelia, lipomeningomyelocele and a small intraspinal cystic lesion. The boy was then operated upon at the age of 5 years, and histopathological examination of the cystic lesion revealed ectopic dysplastic renal tissue.

Choristoma↗

PubMedDate not supplied

[Vascular regions of the spinal cord].

In a material of 50 spinal cord specimens obtained from adults the radicular-anastomotic arteries were studied. After an analysis of the situation, diameter and connections of these arteries seven vascular regions were discerned in the cord: upper cervical region C1-C3, middle cervical region C4-C5, cervical intumescence region C6-C8, upper thoracic region Th1-Th3, middle thoracic region Th4-Th7, thoracolumbar intumescence region Th8-L4, and lumbosacral region L5-Co. Arterial systems found in these regions are described.

Adult↗

PubMed1977

Radiation tolerance of the rat spinal cord: time-dose relationships.

The cervical or lumbosacral region of the rat spinal cord was irradiated with 300-kV x rays. Syndromes of radiation myelopathy similar to those in man were observed in rats. Iso-effect curves for tolerance in relation to the number of fractions at daily intervals have a slope of 0.44 and 0.42 on a log-log scale for the cervical and lumbosacral regions, respectively. With intervals of up to 7 days, no significant further increase in tolerance was observed. Low dose rate treatments indicate a half-time of 1.5 hr. for repair of subeffective damage. These results suggest that tolerance of the spinal cord depends very strongly on the number of fractions given and only to a small extent on the overall time of treatment.

Animals↗

PubMedDate not supplied

Correlation study on infrared thermography and nerve root signs in lumbar intervertebral disk herniation patient: a short report.

OBJECTIVE: To determine whether infrared skin thermography is an objective measurement reflecting the seriousness of nerve root irritation in lumbar disk herniation patients. DESIGN: Quantified nerve root signs by physical examination were collected from the patients along with the infrared skin temperature measurement on the lumbosacral region and posterior part of thighs. A correlation study was applied to observe the relation between the nerve root signs and the skin temperature before a successful conservative treatment (mainly spine manipulation), and between the alteration of nerve root signs and that of skin temperature after the treatment. SETTING: Hospitalized care. PATIENTS: Twenty-seven hospitalized samples with computed tomography or magnetic resonance approval were consecutively selected during the latter half of 1990. MAIN OUTCOME MEASURE: Changes in nerve root signs. RESULTS: The temperature difference between a troubled thigh and healthy one is significantly correlated to the score of the nerve root signs before the treatment; and the reduction of temperature difference between two thighs is also significantly correlated with decreasing score of nerve root signs after the treatment. The correlation between the temperature difference on the left and right sides of the lumbosacral region and the nerve root signs before the treatment is insignificant; and the variation of the temperature difference of the same region after the treatment is not correlated with the decreasing score of the nerve root signs. CONCLUSION: Infrared skin thermography of lower extremities might be an objective sign in signaling the soothing process of the nerve root irritation in lumbar disk herniation patients, which may help a doctor in checking the responses of the patient to treatment.

Adult↗

PubMed1982

Closure of large traumatic lumbosacral defects.

The authors describe a new method for the surgical closure of large traumatic defects of the lumbosacral region. In this surgical procedure, longitudinal muscle masses are mobilized to obtain a watertight closure. An anatomical description of the lumbosacral region and a discussion of the importance of anatomy in the development of the procedure are included. Three cases are illustrated.

Adolescent↗

PubMed2003

Lumbosacral ependymomas: a review of the management of intradural and extradural tumors.

OBJECT: The goal of this study was to review the management of intra- and extradural ependymomas. Spinal ependymomas most commonly occur as intramedullary tumors throughout the spinal axis. In the lumbosacral region, ependymomas are most commonly associated with the conus medullaris and cauda equina, but can also occur extradurally in the sacrum, presacral tissues, or subcutaneous tissues over the sacrum. These two tumor locations produce different management concerns. Intradural ependymomas, especially those in the lumbosacral region, are now recognized for their potential to spread throughout the central nervous system (CNS), whereas extradural tumors elicit more concern for their association with extraneural metastases. METHODS: The authors have reviewed the literature regarding both of these distinct tumors and have summarized recommendations for the management of intra- and extradural lumbosacral ependymomas. For both tumors, it appears that gross-total resection is the treatment of choice when feasible. The role of radiation therapy has not been adequately studied for either tumor location, but most clinicians use this modality in patients with subtotal resection of intradural ependymomas, local recurrence, or CNS dissemination. Data supporting the use of radiation therapy for extradural ependymomas are lacking. There does not appear to be a significant role for chemotherapy in either tumor location. CONCLUSIONS: Despite the risk for local recurrence and CNS dissemination, the prognosis for intradural lumbosacral ependymomas is good, with a greater than 90% 10-year patient survival in most series. The prognosis for extradural ependymomas does not appear to be as good. Much depends on extradural tumor location, however; the outlook is better for dorsal sacral tumors than presacral tumors.

Adolescent↗

PubMed1996

Iliolumbar ligament insertions. In vivo anatomic study.

STUDY DESIGN: Using magnetic resonance imaging, this study analyzed the anatomic characteristics of the iliolumbar ligament insertion on humans. OBJECTIVES: To resolve certain anatomic questions about the manner of insertion of the iliolumbar ligament. SUMMARY OF BACKGROUND DATA: The data of the postmortem studies of the iliolumbar ligament are controversial because of the number, complexity, and variability of the structures present in the lumbosacral region. METHODS: Twenty-eight iliolumbar ligaments of 14 adult volunteers were analyzed with magnetic resonance imaging. The images were acquired along the transversal planes (from inferior to superior) and coronal planes (from the ventral to the dorsal) of the lumbosacral region. RESULTS: The anterior band of the iliolumbar ligament (broad and flat) originates from the anterior-inferior-lateral part of the L5 transverse process and expands as a wide fan before inserting on the anterior part of the iliac tuberosity below the posterior band. The posterior band of the iliolumbar ligament originates from the apex of the L5 transverse process and is thinner than the anterior with a round section, and it inserts on the iliac crest (from the anterior margin to the apex). CONCLUSIONS: The minor width of the area of insertion on the iliac crest of the posterior band (and therefore its lower resistance with the mechanical overloads) could explain the frequency of the painful syndromes related, by some authors, to an enthesopathy of this ligament.

Adult↗

PubMed1989

[Two cases of diastematomyelia: its evaluation with MR imaging].

We experienced two cases of diastematomyelia. Magnetic Resonance Imaging (MRI) was very useful in definitive diagnosis and detection of associated abnormalities. Case 1 was a 5-year-old boy. He was admitted because of foot-length discrepancy. He also presented scoliosis, hypertrichosis and pigmentation in his back skin, and foot deformity. Myelography and CT myelography revealed bony septum and split cord at midthoracic level, and two separated taut filum terminalis in the lumbosacral region. Sagittal MR image delineated the taut filum terminale adhering to the lipomatous tissue at the end of dural sac. Removal of the septum and division of the taut filum terminalis were performed. Case 2 was a newborn baby. She was admitted because of bulging of the back skin in the lumbosacral region and foot deformity. Plain CT revealed bony septum at lumbar level. Myelography was not performed. MR image demonstrated the split cord in its entirety, the bony septum and its structures in detail, and the associated lipoma. Removal of the septum and resection of the lipoma were performed. Diastematomyelia has been able to be definitely diagnosed only by myelography or CT myelography. In our case, MR image gave visualization of septum and split cord in its entirety, and also detected the associated anomalies such as lipoma, tight filum terminale. MRI has possibility of becoming a diagnostic technique in place of myelography and CT myelography.

Child, Preschool↗

PubMed1998

Linear focal elastosis: Keloidal repair of striae distensae.

Linear focal elastosis and striae distensae coexisted in a 32-year-old black man in their typical distribution on the lower back. Many striae appeared when he lost 50 lb in 1991. Only some of them became hypertrophic and others remained atrophic; striae distensae of the shoulders and buttocks remained atrophic, whereas most in the lumbosacral region became indurated and cordlike. Histologically, the former lacked elastic fibers and the latter showed a marked increase in thick elastic fibers. Linear focal elastosis in some patients may represent hyperplasia of elastic fibers in response to their damage. This "elastic fiber keloid" seems to be equivalent to collagen keloid, i.e., ordinary keloid, in the lumbosacral region.

Adult↗

PubMedDate not supplied

A review of imaging techniques for canine cauda equina syndrome.

There are many imaging modalities available for evaluating the canine lumbosacral region. These include conventional radiography, stress radiography, myelography, epidurography, transosseous and intravenous venography, discography, linear tomography, computed tomography, and magnetic resonance imaging. Myelography, epidurography and discography are commonly used, but often lack sensitivity. Myelography is of little value when evaluating the cauda equina because the dural sac is elevated from the vertebral canal floor and frequently ends before the lumbosacral junction. Epidurography will identify a ventrally located compressive lesion and discography can delineate the dorsal extent of the diseased disc; however, both are sometimes difficult to interpret. Therefore, more than one of these imaging techniques must be used in order to make a diagnosis. Computed tomography and magnetic resonance imaging have become valuable in evaluating the lumbosacral region in dogs. These modalities have proven to be both sensitive and specific for determining cauda equina compression in both humans and in dogs.

Animals↗

PubMed1977

The craniocaudal extent of the glycogen body in the domestic chicken.

All birds have a glial enclosed, glycogen-containing structure in the lumbosacral region of their spinal cords. Recently, a dorsal, central, glycogen-rich area surrounding the central canal in the brachial spinal cord was described in domestic chickens. In order to topographically delineate and histochemically describe this structure, fresh, frozen serial sections of chicken brains and spinal cords were processed for glycogen content, phosphorylase, succinic dehydrogenase and cholinesterase activities. The glycogen-rich area surrounding the central canal in the lumbosacral region is found at all levels of the spinal cord and lower medulla. In the upper medulla, it is located in the medline floor immediately ventral to the ependyma. It persists in this position until the level of the oculomotor complex where it ends. Phosphorylase positive regions closely parallel the glycogen distribution. No succinic dehydrogenase or cholinesterase activities are found in these areas.

Animals↗

PubMed1987

Activation patterns of embryonic chick lumbosacral motoneurones following large spinal cord reversals.

1. Embryonic chick motoneurones were caused to innervate inappropriate hindlimb muscles by rotating the presumptive lumbosacral region of the neural tube in stage 15-16 embryos which is prior to the outgrowth of motoneurone axons. 2. The activation patterns of motoneurones in control and spinal cord reversal embryos were analysed from electromyographic (e.m.g.) recordings of stage 36 limb muscles during evoked movement sequences in an isolated spinal cord-limb preparation. Histograms representing the frequency of activation were constructed for each muscle. The muscle's pattern of activation was classified as flexor-like or extensor-like and compared to the activation patterns of control muscles. 3. A series of control operations was performed in which the prospective lumbosacral region of the neural tube was removed and replaced in its original orientation. Muscles in these embryos were innervated by their normal motoneurone pools and they were activated normally, indicating that the neural tube operation per se does not alter the activation pattern of motoneurones. Furthermore, some muscles (twelve out of sixty-one) in spinal cord reversal embryos had normal activation patterns and appeared to be innervated by their original motoneurones. Based on these results and the result of a previous study (Landmesser & O'Donovan, 1984 b), it is concluded that motoneurones in reversed spinal cords are activated in a manner appropriate for their original identity. 4. The majority of muscles (thirty-three out of sixty-one) in large spinal cord reversal embryos were activated during an appropriate phase of the kicking cycle. Of the remaining muscles, 16% were activated inappropriately (i.e. extensor muscles were activated as flexors, and vice versa), and 30% had a novel 'mixed' flexor- and extensor-like activation pattern. However, the activation pattern of most muscles differed markedly from that of any other control muscles regardless of whether the muscle was activated appropriately or inappropriately as a flexor or extensor. The abnormal activation patterns are a likely consequence of the diffuse distribution of inappropriate motoneurones projecting to foreign muscles in embryos with large spinal cord reversals. Since it is likely that motoneurones are still activated according to their original identity, the activation patterns of individual foreign motor units projecting to a muscle sum in e.m.g. recordings to produce a novel abnormal activation pattern.(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗