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At least 19 recordsLinked to original sources
PubMed1984

Changes and measurement of height and angle in the lumbosacral region.

A lumbosacral trapezium can be constructed using the parallels to the lower plate L4 and the upper plate S1 and two perpendiculars to the former; it yields exact measurement data for changes in height and curvature in the lower lumbar motion segments. The clinically relevant reductions in height in the dorsal part of the segments L4-5 and L5-S1, the increase in lumbar lordosis, and therapeutic straightening by means of conservative or operative treatment can thus be plotted exactly.

Humans↗
PubMed1998

Surgical management of giant schwannoma in the lumbosacral region.

Giant lumbosacral schwannoma is rare and only 11 cases have been reported. We experienced two cases: a 58-year-old woman with recurrent schwannoma from L2 to S3, and a 52-year-old woman with schwannoma from T12 to L5. Total resection was possible in the latter case, which was the patient's first operation. Although she had neurologic deterioration, there was no recurrence during the 4-year follow-up. The recurrent case required a bone graft because of her fragile spine, and she was severely disabled. In the literature, total resection has been confirmed in only two cases of a first operation. Total resection is nonetheless strongly recommended in spite of the risk of leaving a neurologic deficit.

Cauda Equina↗
PubMed2005

Use of lumbosacral region manipulation and therapeutic exercises for a patient with a lumbosacral transitional vertebra and low back pain.

STUDY DESIGN: Case report. BACKGROUND: A lumbosacral transitional vertebra (LTV) is a congenital anomaly that occurs in 3% to 21% of people with and without low back pain (LBP). There is lack of agreement in the literature as to whether or not the presence of a LTV may cause LBP. The objective of this case report is to present the use of lumbosacral region manipulation and therapeutic exercises on a patient with a known LTV and LBP. CASE DESCRIPTION: In this case report, an active-duty US Army soldier was referred to physical therapy with right-sided LBP and a lumbar radiograph showing a hemisacralized transitional L5 vertebra on the same side as his pain. The patient was treated with lumbosacral region manipulation and flexion exercises aimed at regaining total spinal motion and reducing pain. The patient responded favorably to spinal manipulation and exercise and was discharged from physical therapy after 4 visits. A modified Oswestry Low Back Pain Disability Questionnaire and inclinometer were used to measure outcome after physical therapy intervention. OUTCOMES: After a 2-week period of treatment in physical therapy, the patient improved from an initial Oswestry score of 32% to a score of 4%. Forward bending and left side bending improved from 74 degrees to 140 degrees and from 21 degrees to 45 degrees, respectively. DISCUSSION: Lumbosacral region manipulation along with therapeutic exercises appears to have been an effective treatment approach for this patient with LBP associated with a type IIA LTV.

Adult↗
PubMed1987

Influence of the erect posture on the development of the lumbosacral region. A comparative study on the lumbosacral junction of the monkey, dog, rabbit and rat.

An animal study was carried out to gain better understanding on the effect of erect posture in the development of the lumbosacral junction. Rhesus monkeys which are able to sit in an upright position were compared with quadrupeds, including rats, rabbits and dogs, whose lumbosacral spines are normally more or less horizontal. The important finding was the presence of the iliolumbar ligament in the rhesus monkey which attached to the last, occasionally the second last, lumbar transverse process and the adjacent iliac wing. A similar ligament was absent in the quadrupeds. We postulate that the stresses created across the lumbosacral junction as a result of the erect posture in the rhesus monkey have played an important role in stimulating the formation of this ligament.

Animals↗
PubMed1998

Tuberculous lesions of the lumbosacral region. A 15-year follow-up of patients treated by ambulant chemotherapy.

STUDY DESIGN: A 15-year clinical follow-up of tuberculous lesions of the lumbosacral region. OBJECTIVES: To verify the hypothesis that the lumbar lordosis and the specific biomechanics of the lumbosacral region influence and alter the healing pattern and progress of the disease when compared with their effects in other regions of the spine. SUMMARY OF BACKGROUND DATA: An estimated 2 million or more patients have active spinal tuberculosis, and the global incidence of the disease is increasing. The involvement of the lower lumbar region and the lumbosacral junction is relatively rare, with few reports in English literature. METHODS: Of a total of 304 patients forming a part of a controlled clinical trial comparing two forms of therapy in spinal tuberculosis, 53 patients had involvement of L3 and below. The following data were studied in these patients: age at start of treatment, number of vertebra involved, vertebral body loss, progress of the angle of kyphosis, and anterior and posterior growth of the involved segment during a period of 15 years. Student's t test for independent samples was used for statistical analysis. RESULTS: The fourth lumbar vertebra was the most common vertebral segment involved, and the lumbosacral junction was affected in 12 patients. The average pretreatment kyphosis was 6.4 degrees and increased to 10.2 degrees at the end of 15 years. The average kyphotio angle per vertebral body loss was 4.9 degrees, far less than in the dorsolumbar region in which kyphotic angles of 27-30 degrees have been reported. Children younger than 10 years old differed in clinical appearance and progress compared with those older than 17 years. They not only showed more extensive involvement but also had more deformity with the same vertebral loss. Twelve patients less than 10 years old had an average involvement of 3.1 vertebral bodies and an average vertebral loss of 2.2 bodies. In comparison, the average number of vertebrae involved was 1.9 (P < 0.01) and the vertebral body loss was only 0.87 (P < 0.01) in patients older than 17 years. Also, the average kyphosis was 6.4 degrees compared with only 4.2 degrees (P < 0.01) in adults. In patients older than 17 years, there was no change after 2 years, by which time the collapse was complete. Four of 12 patients less than 10 years old, showed progressive kyphosis caused by continued growth of posterior parts of the body (i.e., sequestrated hemivertebrae). CONCLUSIONS: In tuberculosis of the lumbosacral region, the development of kyphosis is minimal in patients older than 17 years, when growth has already stopped, and deformity is expressed more as foreshortening of the trunk. Children younger than 10 years old have more severe involvement with increased tendency toward greater kyphosis. They are also prone to progressive deformity through the years when the anterior growth plates are destroyed. Surgery is indicated in this group to prevent greater deformity.

Adolescent↗
PubMed1995

Variations in the lumbosacral ligament and associated changes in the lumbosacral region resulting in compression of the fifth dorsal root ganglion and spinal nerve.

Sixty-five lumbosacral regions from adult cadavers were dissected and the position and relations of the lumbosacral ligament noted. The lumbosacral ligament was present in all specimens; in 22 (34%) it extended medially across the ventral ramus of the fifth lumbar nerve, and in six (9%) of these the underlying nerve was compressed and visibly flattened. On two of these specimens the nerve, together with its dorsal root ganglion, was removed, processed, and stained with Masson's trichrome. The compressed nerve showed increased thickness of endoneurial and perineurial connective tissue, and the cells of the dorsal root ganglion were smaller and surrounded by increased connective tissue, particularly at the periphery of the ganglion. Observation of the lumbosacral ligament and surrounding anatomical structures suggests that anatomical variation in this region may be attributed to the health of the lumbosacral articular elements. In those specimens showing compression of the fifth lumbar spinal nerve there was also narrowing of the lumbosacral interspace. In these the disc itself was compressed and showed degenerative changes. The articular processes at the lumbosacral joint were irregular, with thinning and fissuring of the artiuclar cartilage. It is suggested that the processes which lead to the further development of the ligament, by the formation of additional fibrous bands, are mechanical in nature and result from instability at the lumbosacral region itself. Instability subsequently leads to the initiation of a chain of degenerative changes, involving pathology at the lumbosacral disc and zygapophyseal joints.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2005

Tuberculous spondylitis of the lumbosacral region: long-term follow-up of patients treated by chemotherapy, transpedicular drainage, posterior instrumentation, and fusion.

OBJECTIVE: Tuberculosis spondylitis of the lumbosacral region has rarely been documented in the literature. We present an 87-month follow-up study of 7 of 62 patients with tuberculous spondylitis of the lumbosacral region treated by chemotherapy, transpedicular drainage, posterior instrumentation, and fusion. The purpose was to prove the hypothesis that chemotherapy with transpedicular drainage and single-stage posterior instrumentation-fusion is enough for the prevention of lumbar kyphosis and sagittal offset in selected cases. METHODS: There were four men and three women, with average age of 53 years. All patients underwent transpedicular debridement, posterior fusion, and instrumentation. We studied the following data for consideration in these patients: most involved vertebra, vertebral body loss, progress of kyphosis, and sagittal offset. RESULTS: The fourth lumbar vertebra was the most commonly involved vertebral segment. The average preoperative kyphosis was 17.5 degrees and decreased to 5.4 degrees postoperatively. Mean preoperative and postoperative sagittal offset was 0.34 mm and -5 mm, respectively. The average postoperative sagittal offset was increased from -5 to -2 mm at the third month and henceforth remained unchanged. There was no recurrent infection. CONCLUSION: We consider that transpedicular drainage, posterior instrumentation, and fusion constitute a less demanding operative technique for lumbosacral tuberculous spondylitis for the prevention of lumbar kyphosis and sagittal offset in patients without neurologic deficit and major vertebral body loss. This is the only lumbosacral tuberculous spondylitis series in which the patients were operated on with single-stage posterior surgery and merits a brief report in the light of the larger series.

Adult↗
PubMed2004

Tuberculous osteomyelitis of the lumbosacral region: a spinal epidural abscess with presacral extension.

INTRODUCTION: Tuberculous osteomyelitis in the lumbosacral region is an uncommon occurrence, and its treatment is not well-defined in the literature, particularly when it is associated with abscess formation. We present the outcome of a patient who had an epidural abscess with presacral extension. MATERIALS AND METHODS: A 30-year-old man had microbiologically confirmed tuberculous infection of the lumbosacral vertebrae complicated by extensive abscess formation. After a trial of chemotherapy, the infection proved refractory, and the treatment proceeded with abscess drainage through the anterior route. RESULTS: Approximately 1 year after surgery, the patient was symptom-free and did not show any significant radiologic changes. CONCLUSION: Antituberculous chemotherapy combined with anterior surgery seems to be beneficial in the setting of lumbosacral osteomyelitis complicated by epidural abscess formation with presacral extension.

Adult↗
PubMed1996

Abnormal anatomy of the lumbosacral region imaged by magnetic resonance in children with anorectal malformations.

OBJECTIVE: To investigate the frequency of lumbosacral anomalies, the association with urogenital abnormalities, and the correlation with defaecation pattern by magnetic resonance imaging (MRI). METHODS: A prospective analysis was performed of routine MRI in patients with anorectal malformations. Between 1990 and 1994, MRI was performed in 43 such patients: 31 boys and 12 girls. Twenty four had a high anorectal malformation, 16 had a low anorectal malformation, and three had Currarino's triad. MRI was performed before reconstruction in 26, and postoperatively in 17. Urogenital anomalies were found in 21. RESULTS: Abnormalities of the spinal cord and spine were found with MRI in 20 patients (46.5%); caudal regression syndrome in 10, tethered cord in two, a combination of both in three, and other spinal anomalies in five. These anomalies were found in 30% of the patients with low anorectal malformations, and in 50% with high anorectal malformations. In patients with urogenital malformations, MRI more often showed spinal anomalies (13/21, 62%) than in patients without (7/22, 32%). In high anorectal malformations, defaecation was more often a problem in patients with spinal anomalies (12/15, 80%) than in patients without (2/8, 25%). CONCLUSIONS: Spinal anomalies in the lumbosacral region were found with MRI in 46.5% of patients with anorectal malformations. Since presence of these anomalies seems to be related to clinical outcome, MRI should be performed routinely in all such patients.

Abnormalities, Multiple↗
PubMed1993

Dorsal root ganglia in the lumbosacral region observed from the axial views of MRI.

A total number of 442 dorsal root ganglia (DRG) in the lumbosacral region of 104 patients were depicted from the axial views of MRI and their localities were classified as intraspinal, intraforaminal, or extraforaminal types. The DRG of the more distal nerve root were located more medially. Asymmetrical locations were observed in 25 pairs of DRG among 221, of which the symptomatic side tended to locate either medially or proximally compared with those on the asymptomatic side.

Adult↗
PubMed1985

Surgically confirmed myelographic classification of congenital intraspinal lipoma in the lumbosacral region.

Twenty-four cases of histologically confirmed congenital intraspinal lipoma of the lumbosacral region were studied by means of myelography with metrizamide. The findings were compared with intraoperative observations. Myelography with metrizamide clearly revealed the detailed intrathecal structures and allowed a classification of intraspinal lipomas into four types, in terms of their insertion into the conus medullaris: dorsal type, either with direct or indirect (via an intrathecal stalk) insertion of the extrathecal lipoma into the dorsal aspect of the conus medullaris; caudal type; combined type; and filar lipoma. Based on our surgical experience in untethering and decompression of the lesions, the classification was found to be useful in designing a safe and effective surgical procedure which minimized all possible trauma to the intrathecal neural structures.

Adolescent↗