Sacrum

BACKGROUND: The piriformis muscle is normally involved in piriformis syndrome and can be treated with botulinum neurotoxin using several different injection methods. However, definitive injection guidelines for the muscle have not been reported previously. AIMS: This study aimed to determine the ideal area for injections based on the intramuscular nerve distribution as obtained using a modified Sihler's staining technique. MATERIALS AND METHODS: A modified Sihler's method was applied to the piriformis muscle in 15 specimens...

Evidence suggests that preventive dressings applied on sacral skin help to prevent pressure ulcers. However, possible performance differences of different dressing types are unclear. An exploratory randomized crossover trial with intra-individual comparisons was conducted to compare the effects of three different multi-layer foam dressings (Mepilex Border Sacrum, ALLEVYN Life Sacrum and Optifoam Gentle Sacrum) compared to no dressing on the sacral skin. Healthy female volunteers (n = 12, mean age 72 years) wore three different dressings on their sacral skin for 3...

Introduction: Upper extremity lymphedema can complicate mastectomy, lymph node dissection, and radiation. The purpose of this study is to present the outcomes of shoulder arthroplasty in patients with lymphedema. Methods: The 19 shoulders with a shoulder arthroplasty and lymphedema on the surgical side (6 anatomic, 12 reverse, 1 hemiarthroplasty) were followed for four years (1-10 years). There were 2 males and 17 females; average age was 67.8 (48-86) years. Breast carcinoma was the most common reason for lymphedema (75%)...

STUDY DESIGN: A retrospective cross-sectional study. OBJECTIVE: This study aims to determine whether the sacroiliac (SI) joint motion correlated to pelvic incidence (PI) change from standing to supine position in patients with degenerative spinal diseases. SUMMARY OF BACKGROUND DATA: PI was found an unstable parameter after adolescence as the fixed nature of PI was challenged by several studies. The SI joint has been shown to have some motion, age-related degenerative changes of cartilage and SI ligaments contribute to SI joint instability...

Background: Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case: A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection...

WHO describes "low back pain" (LBP) as the most common problem in overall occupational-related diseases. The aim of this study was to evaluate characteristics of spinal functionality among sedentary workers and determine usability of the SpinalMouse® skin-surface measurement device in workplace settings in a risk population for LBP. The spinal examination was implemented at National Instruments Corporations' Hungarian subsidiary, Debrecen in October, 2015, involving 95 white-collar employees as volunteers to assess spinal posture and functional movements...

The present study is aiming to describe clinical characteristics, surgical flowchart and treatment results of eleven adolescent patients with primary aneurysmal bone cyst (ABC) of sacrum and review in the literature. We retrospectively reviewed eleven young patients with sacral primary ABC, which had the intact clinical and follow-up information at our bone tumor center from 2001 to 2018. The literature review was based on Google Scholar, Medline, EMBASE and Pubmed databases. The search was performed using terms of "aneurysmal bone cyst", "sacral tumor", "sacrum tumor" "spine tumor" and "spinal tumor" for the literature review from 1998 to 2019...

Intraoperative localization within the thoracic spine in the prone position may be particularly difficult on account of absence of common landmarks such as the sacrum or the C2 vertebra, thus increasing the potential for wrong-level surgery that may lead to patient morbidity and potential litigation. Some current localization methods involve implantation of markers that are invasive and serve to add to procedural expense while yet still failing to entirely eliminate errors. We describe a novel, non-invasive, and inexpensive technique for intraoperative localization of the thoracic spine in the prone position using an esophageal temperature probe...

Background: In this experimental study, we evaluated the use of digital 3D navigation printing in minimizing complications arising from sacroiliac screw misplacement. Methods: A total of 13 adult pelvic specimens were studied using 3D navigation printing. Mimics software was used for preoperative planning and for obtaining sacrum median sagittal resection and long axis resection of the S1 pedicle center by 3D segmentation. The ideal screw path had its origin at the post-median part of the auricular surface of the sacroiliac joint, the midpoint at the mid-position of the lateral recess and outlet of the anterior sacral foramina; and the endpoint at the S1 sagittal resection...

Sex estimation by various forensic anthropology approaches is a crucial factor for identification of human skeletal remains. However, inexpensive, uncomplicated and reliable methods are still required, especially in a remote crime scene and a high crime incidence area. Here, we examined 13 sacral parameters from 78 independent skeletons derived from deceases found in Central Thailand (male, n = 46; female, n = 32) using simple standard anthropometric techniques for sex allocation. Discriminant analysis exhibited that anterior-posterior diameter of S1 vertebra corpus (APS) is the most accurate sacral parameter for sex determination in our study with 82...

Solitary primary bone lymphoma of the sacrum is rare. We report a case of a 77-year-old male patient who presented with unexplained numbness and pain in the right lower extremity for over 2 months. Tumor markers and other laboratory were unremarkable. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) revealed a solitary osteolytic bone lesion of the sacrum with intense 18 F-FDG uptake (SUVmax=10.7). The subsequent biopsy confirmed the diagnosis of diffuse large B-cell lymphoma...

BACKGROUND: Insufficiency fractures of the sacrum are being detected increasingly more frequently, whereby their incidence will no doubt increase further as a result of the rise in life expectancy. OBJECTIVE: The clinical appearance of sacral insufficiency fractures, the treatment approach taking into account the clinical outcomes and the DRG proceeds are discussed on the basis of clinical examples. PATIENTS AND METHODS: Three female patients (average age 78...

Subarachnoid fat is an uncommon finding that has several etiologies. It is important to determine the etiology in order to plan appropriate treatment. We present a case report of an 80-year-old female brought to the emergency department after a fall with complaints of headache and pain in the sacral region. Computed tomography and magnetic resonance images of the head demonstrated fat in the subarachnoid space. Computed tomography and magnetic resonance images of the sacrum demonstrated a Tarlov cyst with a sacral fracture extending into the cyst, likely representing the origin of the fat in the subarachnoid space...

Bertolotti syndrome is a commonly missed cause of intractable back pain that affects 4% to 8% of the general population. It involves the congenital malformation of a transitional lumbosacral vertebra, with total or partial and unilateral or bilateral transverse process (TP) fusion or articulation to the sacrum. The pain can be debilitating, and the tethering of the spine to the sacrum can encourage deformity formation in the coronal plane and lead to early degenerative changes, especially if present only unilaterally...

PURPOSE: To describe relationships between subepidermal moisture (SEM) and visual skin assessment of pressure injury (PI) in children. DESIGN: Prospective descriptive study. SUBJECTS AND SETTING: Twenty-four participants aged 8 to 16 years recruited from a pediatric orthopedic unit in a children's hospital in Ireland. METHODS: Subepidermal moisture measured with the SEM scanner (Bruin Biometrics, Los Angeles, California) ranged from 0 to 7 picoFarads [pF], and visual observation of trunk and heels occurred daily for 3 days after admission to the unit and/or after surgery...

BACKGROUND AND PURPOSE: There is growing evidence on the role of carbon-ion radiotherapy (C-ion RT) for gynaecological tumours. Pelvic insufficiency fracture (PIF) decreases the quality of life after photon beam radiotherapy (RT). However, there is little information on PIF after C-ion RT. This study retrospectively assessed incidence of PIF after C-ion RT for uterine carcinomas (UCs) and the associations of clinical and dosimetric parameters with PIF incidence. MATERIAL AND METHODS: We performed a pooled analysis of 102 patients with UCs who underwent definitive C-ion RT alone and were followed up for >6 months without any additional RT in the pelvic region...

BACKGROUND: Differentiation of multiple myeloma (MM) from osteolytic metastatic (OM) bone lesions may be critical in patients with lytic bone lesions but can be challenging for radiologists. PURPOSE: To determine whether computed tomography (CT) can be used to distinguish between MM and other OM bone lesions. MATERIAL AND METHODS: In this retrospective study, 320 lesions of 207 patients diagnosed with MM or OM, based on biopsy or clinical examination, were evaluated...

BACKGROUND: The aim of this study was to estimate the incidence of second-degree perineal tears, obstetric anal sphincter injuries (OASI), and high vaginal tears in primiparous women, and to examine how sociodemographic and pregnancy characteristics, hereditary factors, obstetric management and the delivery process are associated with the incidence of these tears. METHODS: All nulliparous women registering at the maternity health care in Region Örebro County, Sweden, in early pregnancy between 1 October 2014 and 1 October 2017 were invited to participate in a prospective cohort study...

The rules of the anatomical nomenclature are sometimes in conflict with the principles of revision of the nomenclature. This is possibly most obvious is the debate about the use of the Latin words pudendus ("shameful") and sacer ("holy") in the anatomical nomenclature. The principles of revision stress preservation of traditional terms even if there are etymological concerns. On the other hand, the nomenclature rules state that anatomical names should, preferably, have informative or descriptive value and that the official Latin terms are the basis for translations of the international standard terminology into modern, vernacular languages...

The definition of pudendum is external genitalia. The term pudendum is used to describe external genitalia regardless of sex. The labia majora, labia minora, clitoris, penis, scrotum, testes, etc. are all parts of the human pudenda. The female pudendum is also called the vulva. Also, non-human species have pudenda. Pudendum is a term that has been part of the formal anatomical nomenclature for a millennium. Recently, the meaning of pudendum has been perverted and misinterpreted as synonymous with only the vulva and to come from an etymological root term with the narrowly defined meaning "to be ashamed...