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https://www.readbyqxmd.com/read/28523383/anterior-sacral-meningocele-presenting-as-intracystic-bleeding
#1
Ignacio Javier Gilete-Tejero, Marta Ortega-Martínez, Jacinto Mata-Gómez, María Rico-Cotelo, Luis Miguel Bernal-García, Beatriz Yerga-Lorenzana, Ignacio Casado-Naranjo
PURPOSE: To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions. METHODS: A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum...
May 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28521343/tarlov-cyst-causing-sacral-insufficiency-fracture
#2
Ross C Puffer, Marcus J Gates, William Copeland, William E Krauss, Jeremy Fogelson
BACKGROUND AND IMPORTANCE: Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. CLINICAL PRESENTATION: The patient is a 38-year-old female who started to develop left low back pain and buttock pain that rapidly progressed into severe pain with some radiation down the posterior aspect of her left leg...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28515594/radiofrequency-ablation-of-osteoid-osteoma-in-common-and-technically-challenging-locations-in-pediatric-population
#3
Shaileshkumar Garge, Shyamkumar N Keshava, Vinu Moses, George K Chiramel, Munawwar Ahmed, Suraj Mammen, Vrisha Madhuri
CONTEXT: Percutaneous radiofrequency ablation (RFA) of osteoid osteoma has a high technical and clinical success rate. However, there is limited data on its use in the pediatric population, especially in technically challenging locations. OBJECTIVE: To assess the safety and efficacy of computed tomography (CT)-guided percutaneous RFA of osteoid osteoma in pediatric population. PATIENTS AND METHODS: From June 2009 to May 2014, 30 patients with osteoid osteoma were treated with CT-guided RFA in common (25 cases) and technically challenging (five cases: four near articular surface and one in sacrum) locations...
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28515451/hoxa7-hoxa9-and-hoxa10-are-differentially-expressed-in-clival-and-sacral-chordomas
#4
Daniela Jäger, Thomas F E Barth, Silke Brüderlein, Angelika Scheuerle, Beate Rinner, Adrian von Witzleben, André Lechel, Patrick Meyer, Regine Mayer-Steinacker, Alexandra von Baer, Markus Schultheiss, Christian R Wirtz, Peter Möller, Kevin Mellert
Chordomas are rare tumours of the bone arising along the spine from clivus to sacrum. We compared three chordoma cell lines of the clivus region including the newly established clivus chordoma cell line, U-CH14, with nine chordoma cell lines originating from sacral primaries by morphology, on genomic and expression levels and with patient samples from our chordoma tissue bank. Clinically, chordomas of the clivus were generally smaller in size at presentation and patients with sacral chordomas had more metastases and more often recurrent disease...
May 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28508761/posterior-branches-of-lumbar-spinal-nerves-part-ii-lumbar-facet-syndrome-pathomechanism-symptomatology-and-diagnostic-work-up
#5
Katarzyna Kozera, Bogdan Ciszek, Paweł Szaro
Posterior branches of the lumbar spinal nerves are the anatomic substrate of pain in the lower back, sacrum and the gluteal area. Such pain may be associated with various pathologies which cause pain in the posterior branches of the lumbar spinal nerves due to entrapment, mechanical irritation or inflammatory reaction and/or degeneration. The posterior branches are of significant functional importance, which is related to the function of the structures they supply, including facet joints, which are the basic biomechanical units of the spine...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28507828/multiple-large-perineural-tarlov-cysts-in-the-sacrum-of-a-cadaver-a-case-report-and-review
#6
Jocelyn Gonzales, Joe Iwanaga, Nitsa Topale, Rod J Oskouian, R Shane Tubbs
Tarlov or perineural cysts are cerebrospinal fluid (CSF)-filled sacs found between the perineurium and epineurium of the nerve roots. It is still unsure whether the origin of these cysts is intradural or extradural. They can either be asymptomatic or create a variety of negative impacts on comfort and quality of life. In this case report, we describe the presentation of multiple Tarlov cysts including one large cyst discovered during a routine cadaveric spinal dissection and the relevant and related literature...
April 12, 2017: Curēus
https://www.readbyqxmd.com/read/28494507/subepidermal-moisture-detection-of-pressure-induced-tissue-damage-on-the-trunk-the-pressure-ulcer-detection-pud-study-outcomes
#7
Barbara M Bates-Jensen, Heather E McCreath, Anabel Patlan
We examined the relationship between subepidermal moisture measured using surface electrical capacitance and visual skin assessment of pressure ulcers at the trunk location (sacral, ischial tuberosities) in 417 nursing home residents residing in 19 facilities. Participants were on average older (mean age of 77 years), 58% were female, over half were ethnic minorities (29% African American, 12% Asian American, and 21% Hispanic), and at risk for pressure ulcers (mean score for Braden Scale for Predicting Pressure Ulcer Risk of 15...
May 11, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28491166/toothpick-meningitis
#8
Qiao Zhou, Neera Singh, Bradley Monteforte
A 66-year-old male with a history of hypertension, back pain, diverticulosis and anal fistula presents with acute onset syncopal episodes, worsening back pain, and altered mental status. The patient exhibited considerable leukocytosis but was hemodynamically stable. CT imaging of the head revealed a gas pattern in the posterior fossa and velum interpositum. CT imaging of the abdomen and pelvis revealed a needle-like foreign body traversing the left sacrum to the sigmoid colon. A lumbar puncture revealed meningitis...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28490249/novel-single-marker-approach-to-estimation-of-lower-extremity-movement
#9
Fateme Navvab Motlagh, Ahmad Reza Arshi
Sacrum motion is used extensively in studying the biomechanical characteristics of walking. This study aimed at investigating the potential of sacrum motion to provide an estimation of important gait events in conjunction with predicting the motion of lower extremity segments. Three-dimensional trajectories of 37 reflective markers placed on anatomical landmarks of 14 healthy subjects were recorded while walking at self-selected normal walking speed on treadmill. Elevation angles of lower extremity segments in sagittal plane were estimated using the lower extremity markers...
May 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28475447/accuracy-of-ultrasound-thermography-and-subepidermal-moisture-in-predicting-pressure-ulcers-a-systematic-review
#10
A L Oliveira, Z Moore, T O Connor, D Patton
OBJECTIVE: Our aims were to: establish the clinical significance of ultrasound, thermography, photography and subepidermal moisture (SEM) measurement; determine the accuracy of ultrasound, thermography, photography and SEM measurement in detecting skin/tissue damage; determine the relative accuracy of one of these assessment methods over another; make recommendations for practice pertaining to assessment of early skin/tissue damage. METHOD: The following databases, Cochrane Wounds Group Specialised Register, The Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid EMBASE, Elsevier version, EBSCO CINAHL, ClinicalTrials...
May 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28474111/ct-guided-transosseous-soft-tissue-biopsy-techniques-outcomes-and-complications-in-50-cases
#11
Monzer Chehab, Stephen Zintsmaster, Syed Zafar Jafri, Mark Richards, Anindya Roy
PURPOSE: To describe the techniques, outcomes and complications of CT-guided transosseous biopsy of soft tissue lesions via multiple different routes. MATERIALS AND METHODS: Clinical and radiologic data from all consecutive soft tissue biopsies performed via a transosseous approach between April 2009 and July 2015 were retrospectively compiled. Fifty biopsies performed in 50 patients (n = 17 males, n = 33 females) were included. Biopsies were performed using a 13-gauge biopsy needle which was advanced through the selected bone to the lesion margin followed by coaxial placement of either an 18- or 20-gauge biopsy gun...
May 4, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28473086/acr-appropriateness-criteria-%C3%A2-stress-fatigue-insufficiency-fracture-including-sacrum-%C3%A2-excluding-other-vertebrae
#12
Jenny T Bencardino, Taylor J Stone, Catherine C Roberts, Marc Appel, Steven J Baccei, R Carter Cassidy, Eric Y Chang, Michael G Fox, Bennett S Greenspan, Soterios Gyftopoulos, Mary G Hochman, Jon A Jacobson, Douglas N Mintz, Gary W Mlady, Joel S Newman, Zehava S Rosenberg, Nehal A Shah, Kirstin M Small, Barbara N Weissman
Stress fractures, including both fatigue and insufficiency types, are frequently encountered in clinical practice as a source of pain in both athletes and patients with predisposing conditions. Radiography is the imaging modality of choice for baseline diagnosis. MRI has greatly improved our ability to diagnose radiographically occult stress fractures. Tc-99m bone scan and CT may also be useful as diagnostic tools. Although fatigue and insufficiency fractures can be self-limited and go onto healing even without diagnosis, there is usually value in initiating prompt therapeutic measures as incomplete stress fractures have the potential of progressing to completion and requiring more invasive treatment or delay in return to activity...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28472486/re-operation-after-long-segment-fusions-for-adult-spinal-deformity-the-impact-of-extending-the-construct-below-the-lumbar-spine
#13
Christopher D Witiw, Richard G Fessler, Stacie Nguyen, Praveen Mummaneni, Neel Anand, Donald Blaskiewicz, Juan Uribe, Michael Y Wang, Adam S Kanter, David Okonkwo, Paul Park, Vedat Deviren, Behrooz A Akbarnia, Robert K Eastlack, Christopher Shaffrey, Gregory M Mundis
BACKGROUND: Deciding where to end a long-segment fusion for adult spinal deformity (ASD) may be a challenge, particularly in the absence of an abnormality at L5/S1. Some suggest prophylactic extension of the construct to the sacrum and/or ilium (S/I) to protect against distal junctional failure, while others support terminating in the lower lumbar spine to preserve motion. OBJECTIVE: To compare the risk of re-operation after long-segment fusions for ASD that ends at L4 or L5 (L4/5) vs S/I...
May 3, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28462895/irradiation-of-anatomically-defined-pelvic-subsites-and-acute-hematologic-toxicity-in-anal-cancer-patients-undergoing-chemoradiation
#14
Brent Rose, Devarati Mitra, Theodore S Hong, Kyung-Wook Jee, Andrzej Niemierko, Lorraine N Drapek, Lawrence S Blaszkowsky, Jill N Allen, Janet E Murphy, Jeffrey W Clark, David P Ryan, Jennifer Y Wo
PURPOSE: Chemoradiation for the treatment of anal cancer is known to cause significant hematologic toxicity (HT). We sought to investigate if radiation dose to specific pelvic subsites is associated with increased HT risk. METHODS AND MATERIALS: Forty-five patients with nonmetastatic anal cancer who received definitive chemoradiation with intensity modulated radiation therapy and concurrent mitomycin-C and 5-fluorouracil were studied. Total pelvic bone marrow (TBM) was divided into 3 subsites: lumbosacral bone marrow (LSBM), including the entire sacrum and L5 vertebral body; iliac bone marrow (IBM) extending from the iliac crests to the superior border of the femoral head; and lower pelvic bone marrow, including the pubic bones, ischia, acetabula, and proximal femurs...
March 23, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28455623/classification-of-normal-sagittal-spine-alignment-refounding-the-roussouly-classification
#15
Féthi Laouissat, Amer Sebaaly, Martin Gehrchen, Pierre Roussouly
PURPOSE: Although the Roussouly classification of common variants in spinal sagittal alignment is well accepted, no studies have implemented it in an asymptomatic adult population. In addition, no study investigated the radiographic features of asymptomatic patients with an anteverted pelvis. The aim of this prospective radiographic study of 296 asymptomatic adults without spinal pathology was to investigate how the Roussouly classification could include the anteverted pelvis concept...
April 28, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28453451/sensitivity-for-palpating-lumbopelvic-soft-tissues-and-bony-landmarks-and-its-associated-factors-a-single-blinded-diagnostic-accuracy-study
#16
Ana Paula Antunes Ferreira, Luciana Cid Póvoa, José Fernando Cardona Zanier, Dequitier Carvalho Machado, Arthur de Sá Ferreira
BACKGROUND: Evidence on the diagnostic performance of palpatory methods and possible confounding factors is scarce. OBJECTIVES: To examine the sensitivity of palpatory methods for location of lumbopelvic landmarks and to assess its association with personal characteristics. METHODS: Eighty-three participants (41 men, 55.6 (16.5) years, 25.9 (4.8) kg/m2 [mean (SD)]) were enrolled in this single-blinded study. Fourteen body and softy-tissue landmarks were sequentially palpated from the spinous process of L4 to the ischial tuberosity...
April 21, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28451403/successful-treatment-with-denosumab-in-a-patient-with-sacral-giant-cell-tumor-of-bone-refractory-to-combination-therapy-with-arterial-embolization-and-zoledronic-acid-a-case-report
#17
Shunji Nishimura, Kazuhiko Hashimoto, Akihiro Tan, Yukinobu Yagyu, Masao Akagi
Giant cell tumor of bone (GCTB) is commonly treated with surgery; however, surgery of GCTB in the sacrum may be challenging due to the associated risk. A conservative approach may be selective arterial embolization or zoledronic acid (ZOL) treatment; however, there are currently no studies investigating the efficacy of combining these two treatments. Denosumab may also be used; however, to the best of our knowledge, there are no reports of a stepwise approach for the use of all three treatments in a single patient...
March 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28448364/deep-tissue-pressure-injury-a-clinical-review
#18
Ave Preston, Aditi Rao, Robyn Strauss, Rebecca Stamm, Demetra Zalman
: A deep tissue pressure injury (DTPI) is a serious type of pressure injury that begins in the muscle closest to the bone and may not be visible in its early stages. Its hallmark is rapid deterioration despite the use of appropriate preventive interventions. In 2007, the National Pressure Ulcer Advisory Panel added suspected deep tissue injuries to the traditional classification system, and by 2010 DTPIs had accounted for about 9% of all pressure injuries and were for the first time more prevalent than stage 3 or 4 pressure injuries...
May 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28435114/the-decussating-fibers-of-the-lumbar-thoracolumbar-fascia-a-landmark-for-identifying-the-l5-spinous-process
#19
Fernando Alonso, Tarush Rustagi, Christian Fisahn, Doniel Drazin, Brady Gardner, Joe Iwanaga, Jens R Chapman, Rod J Oskouian, R Shane Tubbs
INTRODUCTION: The thoracolumbar fascia has been well studied and is known to have crisscrossing fibers. Based on surgical experience, we have hypothesized that the decussating fibers of this fascia may indicate a specific vertebral level. Therefore, the following anatomical study was performed. METHODS: Twenty adult fresh frozen cadavers aged 72-84 years old at death were placed in the prone position and the skin of the lumbar and upper sacrum was removed. Careful attention was given to the thoracolumbar fascia and any fibers of it that grossly crossed the midline to inderdigitate with its contralateral counterpart...
April 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28434542/the-neandertal-vertebral-column-2-the-lumbar-spine
#20
Asier Gómez-Olivencia, Mikel Arlegi, Alon Barash, Jay T Stock, Ella Been
Here we provide the most extensive metric and morphological analysis performed to date on the Neandertal lumbar spine. Neandertal lumbar vertebrae show differences from modern humans in both the vertebral body and in the neural arch, although not all Neandertal lumbar vertebrae differ from modern humans in the same way. Differences in the vertebral foramen are restricted to the lowermost lumbar vertebrae (L4 and L5), differences in the orientation of the upper articular facets appear in the uppermost lumbar vertebrae (probably in L1 and L2-L3), and differences in the horizontal angle of the transverse process appear in L2-L4...
May 2017: Journal of Human Evolution
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