Cases reported "Sciatica"

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1/11. Metastatic meningioma in the sacrum: a case report.

    STUDY DESIGN: This report describes a 51-year-old woman with a sacral metastatic meningioma that originated from an intracranial meningioma. OBJECTIVES: To describe an unusual presentation of a metastatic meningioma in the sacrum. SUMMARY OF BACKGROUND DATA: Extracranial metastases of meningioma are very rare. The phenomenon of metastasis may have more to do with the ability to invade the wall of a blood vessel than with the mitotic activity of a tumor. Therefore, metastases of the meningioma can occur even with a benign histologic picture in the original intracranial meningioma. methods: A 51-year-old woman had experienced low back pain and sciatica of the left leg for several months. Plain radiographs of the lumbosacral spine showed an osteolytic lesion with an irregular margin that occupied the left side of the sacrum. magnetic resonance imaging revealed a soft mass invading the left sacrum, ilium, and presacral space. RESULTS: Surgical removal of the sacral tumor via an anterior-posterior-anterior approach was done. Histopathologic examination revealed a metastatic meningioma with a meningotheliomatous histologic composition. Sixteen months after excision of the metastatic sacral lesion, the patient was ambulating freely and experiencing mild constipation and urine retention. CONCLUSIONS: In this case of metastatic meningioma in the sacrum, which is the first such report to the authors' best knowledge, total excision of the tumor was successful.
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ranking = 1
keywords = sacrum
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2/11. abdominal pain secondary to a sacral perineural cyst.

    BACKGROUND CONTEXT: Perineural cysts are commonly found in the sacral region and are incidently discovered on imaging studies performed for the evaluation of low back and/or leg pain. PURPOSE: To report on a patient presenting with abdominal pain secondary to a large sacral perineural cyst. STUDY DESIGN/SETTING: Case report. methods/PATIENT SAMPLE: A 47-year-old woman was referred to a specialized multidisciplinary spine center with complaints of left lower quadrant abdominal pain and left leg pain. Of significant note was the presence of constipation and urinary frequency over the preceding 8 months. physical examination was normal. magnetic resonance imaging of the lumbosacral spine revealed large perineural cysts eroding the sacrum and extending to the pelvis. The presence of abdominal symptoms prompted a neurosurgical consultation. However, after considering the possible risks associated with the surgical procedure, the patient opted to follow the nonsurgical route. RESULT AND CONCLUSIONS: Although commonly visualized, sacral perineural cysts are rarely symptomatic. When symptomatic, it may be secondary to its size and location. Presence of abdominal pain in a patient with back and/or leg pain should prompt the evaluation of the lumbosacral spine.
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ranking = 0.125
keywords = sacrum
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3/11. A malignant peripheral nerve-sheath tumour responding to chemotherapy.

    A malignant peripheral nerve-sheath tumour developed in the right S1 nerve root in a man aged 30 causing back pain and sciatica. CT and MRI revealed a destructive tumour of the sacrum invading the retroperitoneal space. The tumour was not resectable with an adequate margin. Chemotherapy, consisting of high-dose ifosfamide followed by a combination of vincristine, doxorubicin and cyclophosphamide, was given with success. Malignant peripheral nerve-sheath tumours are thought to respond weakly to chemotherapy, but the response in our patient was complete.
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ranking = 0.125
keywords = sacrum
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4/11. Primary hydatid disease of sacrum affecting the sacroiliac joint: a case report.

    STUDY DESIGN: A case report of hydatid disease of the spine. OBJECTIVE: To describe an unusual case of hydatid disease of the sacrum affecting the sacroiliac joint and to discuss imaging, differential diagnosis, and treatment. SUMMARY OF BACKGROUND DATA: Hydatidosis or echinococcosis affecting the spine is rare and has a characteristic geographic distribution. Signs of sacroiliac joint involvement and accompanying neurologic deficits cause difficulties in differential diagnosis of this rare condition. methods: A case of 38-year-old female patient with low back pain and sciatica was presented. RESULTS: Plain radiographs, computed tomography, and magnetic resonance imaging scans revealed destructive expansive lesion located on the right sacrum and extended through the right sacroiliac joint. Surgical enucleation of the cysts was performed together with mebendazole treatment and histopathologic examination confirmed hydatidosis. CONCLUSION: This unusual disease should be kept in mind in the differential diagnosis of sacroiliac pain and sciatica, especially in endemic areas.
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ranking = 0.75
keywords = sacrum
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5/11. chiropractic management of patients with bilateral congenital hip dislocation with chronic low back and leg pain.

    OBJECTIVE: To discuss conservative methods for treating patients with chronic low back and leg pain associated with the biomechanical and postural alterations related to bilateral congenital hip dislocation. CLINICAL FEATURES: This report describes the cases of 2 adult female subjects with bilateral congenital hip dislocation without acetabula formation who suffered from chronic low back and leg pain managed conservatively by chiropractic methods. The first subject is a 45-year-old woman with a 9-month history of right buttock pain and radiating right leg pain and paresthesia down to the first 2 toes, with a diagnosis of a herniated L4 intervertebral disk. The second subject is a 53-year-old woman who complained of chronic intermittent low back pain and constant unremitting pain on her right leg for the last 3 years. INTERVENTION AND OUTCOME: chiropractic manipulation utilizing Logan Basic apex and double notch contacts, as well as sacroiliac manipulation on a drop table with a sacrum contact and with a posterior to anterior and superior to inferior (PA-SI) rocking thrust, together with a spinal stabilization exercise program, were used on these 2 patients. Both patients had significant clinical improvement, with reduction on the Visual Analogue Scale (VAS) of 67% and 84%, Oswestry Disability Index improvement of 73% and 81%, and an improvement on the Harris hip score of 71% and 44%, respectively. CONCLUSION: A conservative management approach, including specific chiropractic manipulation and a spinal stabilization exercise program, can help manage the treatment of adult patients with chronic low back and leg pain related to bilateral congenital dislocation of the hips.
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ranking = 0.125
keywords = sacrum
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6/11. Pelvic ring reconstruction with a vascularized pedicle iliac bone graft for a large sacral schwannoma.

    A case of pelvic ring reconstruction with a vascularized pedicle iliac bone graft for removal of a huge sacral schwannoma is reported. It is necessary to reconstruct a pelvic ring when its integrity is impaired. Spinal instrumentation is essential for a temporary stability of the pelvic ring in the course of complete healing, which at times results in instrumentation failure. Several cases of pelvic ring reconstruction using vascularized fibular bone grafts have also indicated positive results attributable to their good blood circulation, but techniques with them are relatively complicated. We applied a vascularized pedicle iliac bone graft to the pelvic ring reconstruction after resection of a huge sacral schwannoma. When a stable pelvic ring was regained by using a lumbosacral instrumentation technique, a tricortical iliac bone graft with its vascular pedicle was harvested, transported into the dead space, and tied to the right residual sacrum and the left ilium. The vascularized graft healed rapidly, and continuity of the pelvic ring was regained. This method is effective for pelvic ring reconstruction in that it does not require microvascular techniques and rapid bone healing can be obtained.
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ranking = 0.125
keywords = sacrum
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7/11. Giant sacral perineurial cyst. A case report.

    A rare case of giant sacral perineurial cyst, causing sciatic pain, explored by myelography and computerized tomography, is reported. The cyst, associated with large erosion of the sacrum, was poorly visualized on the myelography, because of its large size, whereas it was better defined on CT scan. Sacral perineurial cysts are usually small and asymptomatic and rarely cause radicular symptoms. The radiological diagnosis and the treatment of these nerve root cysts are briefly discussed.
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ranking = 0.125
keywords = sacrum
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8/11. Lumbosciatic pain due to sacral pathology.

    Lesions of the sacrum are a possible, albeit infrequent, cause of low back pain and sciatica. The purpose of this paper is to draw attention to this possibility which, perhaps due to the rarity of sacral pathologies, is often overlooked in the investigation of lumbosciatic pain. This may influence the prognosis because of the consequent delay in diagnosis. Several cases are reported which were initially operated on for radicular disc syndromes with negative results, and only later correctly diagnosed as sacral lesions.
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ranking = 0.125
keywords = sacrum
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9/11. role of computed tomography in patients with "sciatica".

    The computed tomography (CT) findings in 10 patients who presented with lumbosacral radicular symptoms are reported. The CT scans were performed after the more commonly used radiologic studies, including plain films and myelography, had failed to completely define the nature or extent of the underlying disease process. The final diagnoses were metastatic neoplasm to the spine and soft tissue in six cases, primary neoplasm of the sacrum or soft tissue in three cases, and tuberculous osteomyelitis and abscess in one case. The limitations and potential complications of the various radiologic examinations are discussed, and the potential value of CT in selected patients with lumbosacral neuropathy is presented.
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ranking = 0.125
keywords = sacrum
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10/11. Autoamputation of the first sacral nerve roots in spondyloptosis.

    To our knowledge, this is the first reported case of bilateral autoamputation of the first sacral nerve roots in a patient who has spondyloptosis. The authors think that autoamputation occurred in adolescence during a period of rapid forward displacement of the fifth lumbar vertebra on the sacrum. It is postulated that the lack of motor weakness is due to the long-standing nature of the denervation and that other adjacent nerve roots supplying the triceps surae have, over time, increased the power of those muscle fibers not supplied by the first sacral roots. This finding would encourage development of methods for early reduction and fusion in children showing marked restriction of straight leg raising (ie, tight hamstrings) to prevent rapid listhesis and fixation of the fifth lumbar vertebra to the sacrum.
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ranking = 0.25
keywords = sacrum
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