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Yasmin Elkhashab, Andrew Ng
PURPOSE OF REVIEW: Coccygodynia is pain within the coccyx area. The diagnosis is made clinically with symptoms of pain in the coccyx region and worsening pain in sitting position. The initial treatment is conservative therapy. For patients who do not respond to conservative therapies, there are further interventions available. This includes local injection of local anesthetics and steroids, neurolysis of sacral nerve roots, caudal epidural block, pulse radiofrequency (PRF), intra-rectal massage and manipulation, ganglion impar block, levator ani massage and stretching, coccyx manipulation, and coccygectomy...
March 19, 2018: Current Pain and Headache Reports
Christopher R James, Blake E Peterson, Julia R Crim, James L Cook, Brett D Crist
BACKGROUND: Direct anterior approach total hip arthroplasty (THA) with fluoroscopic assistance is growing in popularity. Variables such as pelvic tilt, c-arm technique, and patient positioning can affect the perceived fluoroscopic view. This study evaluates the effect of these variables on the position of the acetabular component. METHODS: Forty-one hips in 40 patients undergoing direct anterior arthroplasty THA with fluoroscopic assistance underwent routine postoperative radiographs and postoperative pelvic computed tomography scan...
February 1, 2018: Journal of Arthroplasty
Angela R Shih, Gregory M Cote, Ivan Chebib, Edwin Choy, Thomas DeLaney, Vikram Deshpande, Francis J Hornicek, Ruoyu Miao, Joseph H Schwab, G Petur Nielsen, Yen-Lin Chen
Chordoma is a rare malignant tumor of bone with high morbidity and mortality. Recently, aggressive pediatric poorly differentiated chordoma with SMARCB1 loss has been described. This study summarizes the clinicopathologic features of poorly differentiated chordoma with SMARCB1 loss in the largest series to date. A search of records between 1990-2017 at MGH identified 19 patients with poorly differentiated chordoma. Immunohistochemical stains were evaluated. Kaplan-Meier survival statistics and log-rank (Mantel Cox) tests compared survival with other subtypes...
February 26, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Hong-Lin Chen, Bin Zhu, Rong Wei, Zhen-Yu Zhou
Patients with a hip fracture are at high risk for pressure injury. A retrospective review of the electronic medical records of consecutive patients with a hip fracture treated in 2016 in a single tertiary hospital in east China were examined to investigate whether time of year affected the incidence of hospital-acquired pressure injury. Data collected included demographic characteristics (patient name, hospital number, age, gender, and body mass index); possible risk factors for pressure injury, such as presence of diabetes mellitus, admission hemoglobin, admission albumin, length of surgery, and the lowest and/or last Braden Scale score before pressure injury developed; and pressure injury information, which included time of occurrence (days after surgery), location (sacrum and coccyx, ischial tuberosity, or heel), stage, and treatment outcome...
February 2018: Ostomy/wound Management
Atsuhiro Imai, Kohei Murata, Atsushi Naito, Yoshinori Kagawa, Kenji Kawai, Takuya Sakamoto, Kohei Murakami, Yoshiteru Katsura, Yoshiaki Ohmura, Toru Masuzawa, Atsushi Takeno, Shinichi Nakatsuka, Hiroshi Takeda, Takeshi Kato, Shigeyuki Tamura
A 30-year-old woman was admittedto the hospital because of fecal occult bloodpositivity . Endoscopic colonoscopy indicated pressure on the right side of the rectum from the wall. Abdominal contrast CT and pelvic MRI revealed a cystic lesion with a maximum diameter of 5 cm on the pre-coccyx andthe right side of rectum. There was no continuity between the tumor andthe uterus/ovary. We diagnoseda pararectal tumor andremovedit via a sacral approach. The cyst was diagnosed as an epidermoid cyst. She was discharged on the 5th postoperative day...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
P Kodumuri, S Raghuvanshi, R Bommireddy, Z Klezl
Introduction The aetiology of coccydynia can be multifactorial, with several associated factors such as obesity, female gender and low mood. The long-term results of operative interventions, such as manipulation under anaesthesia and coccygectomy are variable, ranging from 63-90%. Materials and methods Our aim was to identify whether age, trauma and body mass index (BMI) were independent prognostic factors in coccydynia treatment. All patients who presented to the Royal Derby Hospital with a primary diagnosis of coccydynia between January 2011 and January 2015 who had injections, manipulation under anaesthesia or coccygectomy were included...
January 2018: Annals of the Royal College of Surgeons of England
Ali Seker, Ilker Abdullah Sarikaya, Ozgur Korkmaz, Sercan Yalcin, Melih Malkoc, Ahmet Murat Bulbul
OBJECTIVE: We compared the results of manual therapy combined with steroid injection with single steroid injection in the treatment of persistent coccydynia. PATIENTS AND METHODS: Combined therapy was performed in 21 patients (Group 1) and steroid injection in 23 patients (Group 2). We compared two groups and investigated the combined therapy group in details. Patients were classified according to the underlying cause, BMI, anatomic type of coccyx and duration of symptoms (< 6 or ≥ 6 months)...
December 12, 2017: European Spine Journal
R Q Wu, T Wang, Q Shi, B Xiao, K J Ma, X Chen
OBJECTIVES: To promote the further research on body stature estimation and the innovative applications based on the distances between the anatomical landmarks on body torso surface. METHODS: A specification for the collection of distances between the anatomical landmarks on body torso surface was established. The data of 933 cases of adult population in Yangtze River Delta region were collected. Multiple linear regression method was used to statistical analyse and establish the regression equation of stature estimation...
June 2017: Fa Yi Xue za Zhi
Jigar N Patel, Amit Kumar, Partap Singh Yadav, Rajiv Chadha, Vikram Datta, Subhasis Roy Choudhury
BACKGROUND/PURPOSE: The anal position index (API) defines the normal anal position as the ratio of fourchette-anal distance to fourchette-coccyx distance for females and the scrotum-anal distance to scrotum-coccyx distance for males. In this study, measurement of the API in newborns and infants with anorectal malformations (ARM), using the center of the midline anal dimple (AD) to represent the center of the proposed neoanus, was performed to assess whether or not the AD was located in a significantly abnormal position as correlated with the normal anal position...
November 16, 2017: Journal of Pediatric Surgery
J Webb, M Twiste, L A Walton, P Hogg
AIM OF THE STUDY: To evaluate the effect of three sling fabrics on gluteal interface pressure whilst sitting in a population of wheelchair users and to compare these to data previously collected in a pilot study with a healthy population. MATERIALS AND METHODS: A repeated measures experimental design was used with 32 adult wheelchair users (15 women, 17 men). Healthy population pilot study consisted of 61 participants (51 women, 10 men) recruited from staff and students at The University of Salford...
December 6, 2017: Journal of Tissue Viability
Daniel Diaz-Aguilar, Sergei Terterov, Rudi Scharnweber, Catherine Merna, Stephanie Wang, Shayan Rahman
Background: Saccrococcygeal teratomas (SCT) are derived from embryonic germ cell layers. They frequently present at the base of the coccyx within the pelvis. While these tumors are common in children, they are exceedingly rare in adults. In adults, a majority of these tumors are intrapelvic and associated with a low risk of malignant transformation. Therefore, this contributes to a good prognosis following resection of mostly benign lesions. Case Description: An adult female with chronic pelvic pain presented with a sacral teratoma...
2017: Surgical Neurology International
Venkatraman Indiran, Vadivalagianambi Sivakumar, Prabakaran Maduraimuthu
Study Design: A retrospective, cross-sectional study of 213 patients who presented for abdominal computed tomography (CT) scans to assess coccygeal morphology in the Indian population. Purpose: There have been relatively few studies of coccygeal morphology in the normal population and none in the Indian population. We aimed to estimate coccygeal morphometric parameters in the Indian population. Overview of Literature: Coccygeal morphology has been studied in European, American, Korean, and Egyptian populations, with few differences in morphology among populations...
October 2017: Asian Spine Journal
Regi Freeman, Andrew Smith, Sharon Dickinson, Dana Tschannen, Shandra James, Candace Friedman
BACKGROUND: The cardiovascular and surgical intensive care units had the highest unit-acquired pressure injury rates at an institution. Patients in these units had multiple risk factors for pressure injuries. Various interventions had been used to minimize pressure injuries, with limited results. OBJECTIVES: To evaluate the effect of specialty linens on the rate of pressure injuries in high-risk patients. The specialty linen was a synthetic silklike fabric that addressed the microclimate surrounding the patient, with the purpose of minimizing friction, shear, moisture, and heat...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Takeshi Fujii, Nobuyuki Fujita, Satoshi Suzuki, Takashi Tsuji, Takashi Takaki, Kazuo Umezawa, Kota Watanabe, Takeshi Miyamoto, Keisuke Horiuchi, Morio Matsumoto Masaya Nakamura
Although the number of patients with intervertebral disc (IVD) degeneration is increasing in aging societies, its etiology and pathogenesis remain elusive and there is currently no effective treatment to prevent this undesirable condition. The unfolded protein response (UPR) is a cellular machinery that plays critical roles in handling endoplasmic reticulum (ER) stress, a condition caused by the accumulation of unfolded proteins in the ER lumen. This study aimed to elucidate the potential role of the UPR mediated by pancreatic endoplasmic reticulum kinase (PERK), one of the major ER stress sensors in mammalian cells, in the development of IVD degeneration...
October 28, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Stéphane Ploteau, Roger Robert, Luc Bruyninx, Jérome Rigaud, Katleen Jottard
AIM: To describe a new minimal invasive approach of the gluteal region which will permit to perform neurolysis of the pudendal and cluneal nerves in case of perineal neuralgia due to an entrapment of these nerve trunks. METHOD: Ten transgluteal approaches were performed on five cadavers. Relevant anatomic structures were dissected and further described. Neurolysis of the pudendal nerve or cluneal nerves were performed. Landmarks for secure intraoperative navigation were indicated...
October 26, 2017: Neurourology and Urodynamics
Stylianos Kapetanakis, Grigorios Gkasdaris, Pavlos Pavlidis, Panagiotis Givissis
BACKGROUND: Sacrum is a triangular bone placed in the base of the spine and formed by the synostosis of five sacral vertebrae (S1-S5). Its upper part is connected with the inferior surface of the body of L5 vertebra forming the lumbosacral joint, while its lower part is connected with the base of the coccyx forming the sacrococcygeal symphysis, an amphiarthrodial joint. The existence of four pairs of sacral foramen in both anterior and posterior surface of the sacrum is the most common anatomy...
September 21, 2017: Folia Morphologica (Warsz)
Bogumiła Dampc, Krzysztof Słowiński
Coccygodynia is a problem with a small percentage (1%) of the population suffering from musculoskeletal disorders. This pain is often associated with trauma, falling on the tailbone, long cycling, or by women after childbirth. The reason for the described problem can be the actual morphological changes. Idiopathic coccygodynia causes therapeutic difficulties to specialists of many fields. Unsatisfactory treatment, including coccygectomy tends to seek new solutions. They belong to them techniques exploited in the manual therapy which in their spectrum hold: direct techniques - per rectum as well as indirect techniques taking into account distant structures of the motor organ, remaining in dense interactions with the coccygeal part...
August 31, 2017: Polski Przeglad Chirurgiczny
Suyash Singh, Jayesh Sardhara, Pradeep Sharma, Arun Kumar Srivastava, Kuntal Kanti Das, Kamlesh S Bhaisora, Anant Mehrotra, Awadhesh Kumar Jaiswal, Sanjay Behari, Raj Kumar
Teratomas are one of the most common tumors in newborn with excellent prognosis arises from totipotent primordial germ cells harboring two or three germ cell layers. The tumor has been titled "Great masquerade." The teratomas of sacrococcygeal region present with lower limb weakness, urinary or bowel obstruction, and swelling at lower back or intrauterine mass in ultrasound or complicated delivery. A 2-month-old male child presented with complaints of swelling over lumbosacral region with discharging punctum since birth...
April 2017: Journal of Pediatric Neurosciences
Juan C Cusi, Jiří Moravec, Edgar Lehr, Václav Gvoždík
A new semiarboreal species of the Rhinella festae group is described from montane forests of the Cordillera Azul National Park between 1245 and 1280 m a.s.l. in the Cordillera Oriental, San Martín region, northern Peru. The new species is morphologically and genetically compared with members of the Rhinella acrolopha group (former genus Rhamphophryne) and members of the R. festae group. The new species is characterized by its large size (female SVL 47.1-58.3 mm, n = 4), eight presacral vertebrae, fusion of the sacrum and coccyx, long protuberant snout, snout directed slightly anteroventral in lateral view, cranial crests moderately developed, absence of occipital crest, presence of tympanic membrane, dorsolateral rows of small conical tubercles extending from parotoid gland to groin, hands and feet with long digits, fingers basally webbed and toes moderately webbed...
2017: ZooKeys
Bardia Anvar, Henry Okonkwo
OBJECTIVE: This study examined the efficacy of bedside surgical debridement in a nursing home population. MATERIALS AND METHODS: A retrospective chart review was performed of sacrum, sacrococcyx, coccyx, ischium, and trochanter (SSCIT) region pressure injuries in the Skilled Wound Care practice (Los Angeles, CA). The patient population was refined from 2128 to 227 patients visited 8 or more times during nursing home stays found to have 1 or more SSCIT pressure injuries...
July 2017: Wounds: a Compendium of Clinical Research and Practice
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