• Title/Summary/Keyword: Sacral

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Two Cases of Symptomatic Perineural Cysts (Tarlov Cysts) in One Family - A Case Report

  • Park, Hyun-Jun;Kim, Il-Sup;Lee, Sang-Won;Son, Byung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.174-177
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    • 2008
  • Symptomatic sacral perineural cysts are uncommon. Several hypotheses have been proposed to explain the etiologies of perineural cysts, but the accurate etiologies remain unclear. We experienced two cases of symptomatic sacral perineural cysts (Tarlov cysts) in one family, who presented with perianal paresthesia. Both of them were operated and postoperatively their symptoms were disappeared immediately. We experienced the excellent treatment outcome with the surgical management of symptomatic perineural cysts in the sacral region. We assume that the theory of congenital origin including a familial tendency is the most plausible of the hypotheses that have been proposed.

The Effect of Flexion-distraction Technique and Drop Technique on Pain and Sacral Angle of Patients with Lumbar Spine Herniated Intervertebral Disc (굴곡-신연기법과 낙차 교정법이 허리 척추사이원반 탈출증 환자의 시각적 상사 척도 및 엉치뼈 각에 미치는 영향)

  • Oh, Hyun-Ju;Choi, Seok-Joo;Lee, Kwan-Sub;Choi, Ji-Oun
    • Journal of Korean Physical Therapy Science
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    • v.25 no.3
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    • pp.9-16
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    • 2018
  • Background: In order to find out the effect of therapy methods through Flexion-distraction technique and drop technique on pain, sacral angle of patients with lumbar herniated intervertebral disc targeting patients with lumbar herniated intervertebral disc due to L5-S1. Method: This study was to present the directivity of the therapy method for lumbar herniated intervertebral disc by comparing and analyzing the spinal decompression therapy and provide an effective treatment method to patients with lumbar herniated intervertebral disc by identifying the therapeutic effect of Flexion-distraction technique and drop technique. The research period is March 1, 2018 to June 30, 2018 and subjects are the patients diagnosed as lumbar herniated intervertebral disc due to L5-S1 by their doctor through clinical findings and medical equipment such as X-ray, CT, MRI etc. Among patients who visited and hospitalized in S Orthopaedics located in Daegu and 30 female patients with sacral angle of more than $30^{\circ}$ were randomly classified into 15 people and we carried out treatment three times a week for 8 weeks for 15 people in the experimental group applying Flexion-distraction technique and drop technique and 15 people in the control group applying spinal decompression therapy to compare and analyze the changes in pain, sacral angle of patients with lumbar herniated intervertebral disc. Result: According to the results of this study, changes in the Visual Analogue Scale showed statistically significant differences in both the experimental group and control group(p<.05), while there was statistically significant difference in the comparison between groups before and after measurement of experimental group (p<.05). In the comparison within two groups of sacral angle, both groups showed statistically significant difference(p<.05) but there was no statistically significant difference in the comparison of scores between groups before and after measurement of each group(p>.05). Discussion: All those results the above proved that we need to confirm various benefits of the therapy with the flexion-distraction technique and drop technique, and the findings of the concerned study will possibly become useful information when doctors actually work on a therapy to treat patients with the lumbar herniated intervertebral disc.

Diffuse Large B-cell Lymphoma of the Sacral Nerve Root; Presenting as a Polyradiculoneuropathy

  • Oh, Sung-Han;Noh, Jae-Sub;Chung, Bong-Sub;Paik, So-Ya
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.70-72
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    • 2005
  • Primary spinal cord lymphomas are rare, and are either extra-/intradural masses with leptomeningeal infiltration or intramedullary in nature. The authors present a patient with a diffuse large B-cell lymphoma involving the sacral nerve root, extension to extradural space, and the cranial nerve.

Sacral Intradural Cysticercosis Misdiagnosed as Brain Tumor Metastasis

  • Kim, Seok-Won;Lee, Seung-Myung
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.67-69
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    • 2005
  • Spinal intradural cysticercosis is a rare manifestation of neurocysticercosis that may present as an isolated lesion. We report a case of sacral intradural cysticercosis misdiagnosed as a metastasis through cerebrospinal fluid seeding in a 48-year-old patient who underwent ependymoma surgery 3 months ago. We performed S1-2 laminectomy with the total removal of intradural lesion. The cysticercosis was confirmed histologically. The patient was given albendazole with corticosteroid.

Reconstruction of Sacral Pressure Sores Using Perforator-Based Island Skin Flaps (천공분지에 기저를 둔 도서형 피부피판을 이용한 천골부 욕창의 재건)

  • Moon, Ji Hyun;Lee, Nae Ho
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.62-67
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    • 2000
  • Recently, the incidence of pressure sore has been increased, due to increased number of patients with central nervous system injuries after traffic and industrial accidents or with long term loss of consciousness due to drug intoxication. The management of sacral pressure sore has been improved through the development of myocutaneous flap. However, sacrifice of the deep muscle cause some problems such as intraoperative bleeding, functional disabilities of donor site and further limitation of reconstruction for recurrent pressure sores in paraplegic patients. The development of perforator-based island skin flap introduce a new treatment modality for sacral pressure sores. We used perforator-based island skin flap in 15 cases with reasonable result from January 1998 to February 2000. This flap has a many advantages such as no significant sacrifice of the gluteus maximus muscle, wide rotation arc, reliable blood flow of the perforator, short elevation time for the flap, and no post-operative hindrance to walking in patients who are not paraplegic. There was no significant complication without significant sequelae and donor sites could be repaired primarily.

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The Effect of Wall-squat with Short-Foot Exercise on Pain and Pelvic alignment of Chronic Low Back Pain with Pronated Foot (단축발 운동을 적용한 벽 스쿼트 운동이 엎침발을 동반한 만성 허리통증환자의 통증과 골반 정렬에 미치는 영향)

  • Kim, Nam-Jun;Lee, Han-Suk
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.4
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    • pp.139-151
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    • 2021
  • PURPOSE: This study examined the effects of wall-squat with short-foot exercise on pain, dysfunction, and pelvic alignment in chronic low back pain patients. METHODS: Thirty outpatients diagnosed with chronic low back pain and pronated foot were enrolled in this study. The patients were divided randomly into a wall-squat with short-foot exercise group (WS; n = 15) and a normal wall-squat exercise group (NW; n = 15). These groups performed their respective exercises 15 times, for three sets, three times a week over six weeks. The visual analogue scale (VAS) was used to measure the subjects' pain, and the Roland-Morris disability questionnaire (RMDQ) was used to measure the subjects' dysfunction. A navicular drop test (NDT) was used to measure the subjects' arch height. To assess the patients' pelvic alignment, their lordosis, sacral tilt, lumbar width, sacral width, ilium length, and ilium width were measured by X-ray imaging. RESULTS: Both the WS and NW groups exhibited significant decreases in their VAS and RMDQ scores after exercise (p < .05). The WS group exhibited significant increases in their arch height (p < .05). Significant differences in the VAS, sacral tilt, sacral width, and ilium length were observed between the WS and NW groups (p < .05). CONCLUSION: These results suggest that wall-squat exercise is effective in decreasing the level of pain and dysfunction in chronic low back pain patients. In addition, the wall-squat with short-foot exercise is considered more effective in improving the pelvic alignment than without short-foot exercise. This can be an effective method for the non-pharmacological and non-surgical treatment of chronic low back pain

Effect of Complex Korean Medicine Treatment on Sacral Insufficiency Fracture: A Case Report

  • Jung, Ga Hyeon;Lee, Hyun;Ryu, Hwa Yeon;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.37 no.3
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    • pp.187-192
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    • 2020
  • Sacral insufficiency fractures (SIF) are a common, but often underdiagnosed source of lower back pain without apparent trauma. This report presents the clinical outcome of a 75-year-old female with SIF, and an underlying medical history of osteoporosis and rheumatoid arthritis. She was treated non-operatively, in-hospital, with Korean medicine. Patient progress was assessed using the numerical rating scale and self-reported symptoms. Post-treatment, the numerical rating scale score for pain in her hip decreased from 7 to 2. At admission, the patient was unable to sit, and could only walk 3 m with assistance. At discharge, she could sit for longer than 1 hour and walk further than 200 m unassisted. On the follow-up visit, the patient was asymptomatic, and x-ray scans showed ossification of the sacral and pubic fractures. These results suggest that, Korean medicine can effectively reduce pain and aid rehabilitation in patients with SIF, without the need for surgery.

Selective Neurotomy of Sacral Lateral Branches for Pain of Sacroiliac Joint Dysfunction

  • Kim, Hyo-Joon;Shin, Dong-Gyu;Kim, Hyoung-Ihl;Shin, Dong-A
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.338-343
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    • 2005
  • Objective : The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency [RF] neurotomies for pain arising from sacroiliac Joint dysfunction[SIJD]. Methods : Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac Joints and deep interosseous ligaments. After confirming the positive response [more than 50% of pain relief], sensory stimulation was applied to detect the 'pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. Results : Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus [88%] and S2-upper division [88%]. Ten patients [63%] reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients [31%] reported complete relief [100%]. Five patients [31%] showed moderate improvements. One patient reported failure. Conclusion : RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.

The Effect of Low Back Pain and Pelvic Displacement on Foot Orthosis (발 보조기 착용이 요통환자의 골반 변위와 통증 변화에 미치는 영향)

  • Lee, Wan-Hee;Park, Dae-Sung
    • Journal of Korean Physical Therapy Science
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    • v.12 no.4
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    • pp.57-67
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    • 2005
  • The purpose of this study is to investigate the effect of low back pain(LBP) and pelvic displacement on foot orthosis. Before and after experiments were designed to compare the effect. 21 LBP patients who were the subjects diagnosed of applying foot orthosis for 3 weeks after, investigated about pelvic obliquity angle, displacement of ilium, lumbo-sacral angle by x-ray test which is one of pelvic displacement tests, visual analogue scale is used for LBP measurement. The result show the followings; First, Pelvic obliquity angle was significantly reduced after applying foot orthosis compared before using it(p<.05). Second, Displacement of ilium was significantly reduced after applying foot orthosis compared before using it(p<.05). Third, Lumbo-sacral angle was significantly reduced after applying foot orthosis compared before using it(p<.05). Fourth, LBP was significantly reduced after applying foot orthosis compared before using it(p<.05). This study tries to suggest new LBP treatment to reduce pelvic displacement by apply foot orthosis. In conclusion, foot orthosis reduces pelvic obliquity angle, displacement of ilium, lumbo-sacral angle and also decrease LBP. Further more, It needs of biomechanical study which can recognize relation between foot arch and pelvic displacement. This study will serve as a clinically useful data for diagnosis and treatment of LBP and biomechanical analysis of lower limb.

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Symptomatic Tarlov's Cyst(Sacral Meningeal Cyst) - Case Report - (신경근 압박증상을 동반한 Tarlov씨 낭종 2예 - 증 례 보 고 -)

  • Lim, Kang-Taek;Cho, Byung Moon;Shin, Dong-Ik;Park, Se-Hyuck;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.569-573
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    • 2000
  • Spinal meningeal cyst of the sacrum is uncommon congenital lesion. We experienced two cases of sacral meningeal cyst, so called Tarlov's cyst, who presented with radiating pain. Magnetic resonance imaging is a highly effective way of locating and approximating the size of these entities, which generally appear as intraspinal masses of low intensity on T1-weighted and high intensity on T2-weighted images, similar to cerebrospinal fluid(CSF). We evaluated 2 patients who had Tarlov's cyst diagnosed with conventional MRI. The clinical features, radiological findings, gross appearances of the lesion at surgery, surgical technique, histopathological features of the cyst wall, and surgical outcome are described. We conclude that excellent result can be expected in the case of symptomatic Tarlov's cyst by surgical decompression.

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