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At least 199 records · Page 11Linked to original sources
PubMed1976

Bilateral sacroiliac joint dislocation with intrapelvic intrusion of the intact lumbosacral spine and sacrum.

Two cases of bilateral sacroiliac joint dislocation with intrapelvic intrusion of the intact lumbosacral spine and sacrum are reported. This condition is a distinct traumatic entity. The essential features of this condition are the disruption of the pelvic ring with bilateral sacroiliac dislocation. The spine as a whole descends into the depths of the pelvis. Disruption of the anterior structures but not always the pubic symphysis is apparently a prerequisite for the development of the condition. Extensive soft-tissue damage is part of the injury. The etiology is a direct crushing violence to a standing or walking patient. It is assumed that this injury is less rare than it seems, and that the main reason for not being mentioned is the rarity of the survival of the patients. As a result of success in the intensive care of the severly injured, more survivals and more reports are anticipated.

Adult↗
PubMed1979

Longitudinal fractures of the sacrum: case report.

A longitudinal fracture of the sacrum without an associated neurologic deficit is described. It was treated by bedrest successfully. The case is compared to the usual transverse or oblique sacral fracture: we feel that because the sacral nerve roots were pushed to either side of the fracture there were no neurologic problems in the case presented.

Adult↗
PubMed1979

Displaced transverse fracture of the sacrum with nerve root injury: report of a case with successful operative management.

A displaced transverse fracture of the sacrum occurred in a young woman along with lumbar transverse process fractures, displacement suggesting instability in flexion, and nerve root injury, all features common to this injury. Open decompression, reduction, and Harrington rod fixation were successful for this patient, but the method is not recommended for all sacral fractures.

Adult↗
PubMed1984

Displaced midline longitudinal fracture of the sacrum.

An unstable displaced midline longitudinal (vertical) fracture of the sacrum, apparently not previously reported, is described. Pitfalls in treatment are elucidated. It is recommended that Pennal 's classification be used to categorize all pelvic fractures in order to ensure early and adequate treatment and minimize the occurrence of disabling sequelae. In the patient reported, complications were bladder prolapse, pelvic instability, and sciatic nerve injury.

Adult↗
PubMed1994

Longitudinal fracture of the sacrum: case report.

A 51-year-old woman was involved in a motor vehicle crash, sustaining multiple injuries including a longitudinal displaced burst fracture of the sacrum associated with neurologic deficits and fractures of the pelvis. A computed tomographic scan was valuable in properly identifying the extent of the sacral fracture. Because of the neurologic deficits and displacement of the sacral fracture, decompression of the sacral canal and attempted reduction of the sacral fracture and fixation of the pelvic fracture were performed. The patient's neurologic deficits improved, and at last follow-up examination she was ambulating without assistance.

Female↗
PubMed1988

Fractures of the sacrum and sacroiliac joint: evaluation by computerized tomography with multiplanar reconstruction.

Conventional roentgenographic views of the pelvis provide inadequate assessment of complex bony trauma. Computerized tomography (CT) allows simpler patient positioning, more reliable detection of subtle fractures, better characterization of complex fractures, and detection of associated soft tissue and joint space abnormalities. The addition of multiplanar reconstructions (MPR) provides a better understanding of the pathoanatomy. The sacrum and the sacroiliac joint, traditionally problematic to image, are particularly well defined by CT/MPR. Subtle diastasis and intra-articular fragments are more reliably detected when the transaxial image is supplemented by coronal reconstructions. The degree of comminution and direction of fragment displacement are also best defined by coronal and sagittal formatting. Surgeons often find this protocol useful in preoperative assessment of extent and stability of fractures, and in planning conservative or surgical management.

Adult↗
PubMed1995

Solitary plasmacytoma of the sacrum presenting as a pelvic mass: report of two cases.

We describe two unusual cases of solitary plasmacytoma of the sacrum seen as a pelvic mass. Excessive bleeding, a distinct possibility, should be anticipated whenever a biopsy or resection of the tumor is considered. Because of the tumor's apparent radioresponsiveness and known evolution to multiple myeloma in some cases, radiotherapy and chemotherapy are recommended.

Adult↗
PubMed1978

High amputation of the sacrum for extirpation of tumors. Principles and technique.

A detailed description is given of the principles and surgical technique for extensive resection of the sacrum, including an adjacent part of each ilium, for radical removal of tumor. Two levels of sacral amputation are discussed: between S1 and S2 (through the canals of the S1 nerves) and through S1 (above the canals of the S1 nerves), with or without inclusion of the rectum in the specimen. The former level permits the preservation of the S1 nerves; the latter does not. Important pathoanatomic facts are discussed. The effects of these operations on the urogenital and anorectal function and on the stability of the pelvic girdle are briefly reviewed. Five illustrative cases are reported with comments on the results.

Anal Canal↗
PubMed2004

Giant cell tumor of the pelvis and sacrum: 17 cases and analysis of the literature.

The optimal treatment of giant cell tumors of the pelvis and sacrum is controversial. Our current patient series was combined with cases identified in a review of the literature published in the past 50 years, yielding a combined group of 239 lesions for study. Recurrence rates were 49% for patients who had radiation therapy alone, 47% for patients who had surgery with intralesional margins, 46% for patients who had surgery with intralesional margins and radiation therapy, and 0% for patients who had surgery with wide margins. Six percent of patients had benign lung metastases develop, 2% of patients had secondary malignancies, 2% of patients died in the perioperative period, and less than 1% of patients had multicentricity. Radiation-induced sarcoma developed in 11% of patients who received radiation for primary or recurrent lesions. Larger doses of radiation therapy did not decrease the rate of local recurrence. Recurrence after surgery and radiation was not lower than after either treatment alone. Local recurrence was more likely in the patients with sacral tumors (48%) than in the patients with pelvic tumors (34%). Disease status was worse in the patients with sacral lesions (23% died of disease) than in the patients with pelvic lesions (6% died of disease).

Adolescent↗
PubMed2003

Diagnostic value of open and needle biopsies in tumors of the sacrum.

STUDY DESIGN: A retrospective study with statistical analysis of 25 percutaneous needle biopsies and 54 open biopsies performed on 60 patients with tumors located in the sacrococcygeal region. OBJECTIVES: To analyze the diagnostic value of open and needle biopsies in tumors of the sacrum as well as to determine factors leading to a false or equivocal result. SUMMARY OF BACKGROUND DATA: Although percutaneous needle biopsies of the spine are valuable for thoracolumbar levels, the benefit in the sacrococcygeal region, specifically, has not previously been shown. This region is unique because of anatomic and oncologic factors. METHODS: Medical charts, imaging studies, and operative and pathologic records of patients with tumors diagnosed between 1965 and 1996 in the sacrococcygeal region reviewed were analyzed. Accuracy and effective accuracy of each procedure were then calculated. RESULTS: There were 54 primary lesions (17 benign, 37 malignant) and 6 metastatic tumors. The accuracy and effective accuracy of open biopsies was 87% and 81% but in percutaneous needle biopsies was only 44% and 12%, respectively. An unclear diagnosis resulted in the need for another biopsy in 12 of 21 primary percutaneous needle biopsies but only in 2 of 39 open biopsies (P < 0.0001, chi2). The average number of biopsies required to obtain a definitive diagnosis was significantly less if an open biopsy were performed first instead of a percutaneous needle biopsy, 1.1 versus 1.8, respectively (P = 0.0004, two-sample t test). There was a significant delay in treatment if the initial biopsy was a percutaneous needle biopsy compared with an open biopsy, mean 46 versus 4 days, respectively (P = 0.004, two-sample t test). CONCLUSION: We conclude that for sacral tumors, open biopsies have a higher effective accuracy, whereas needle biopsies are associated with a longer delay in treatment.

Adolescent↗
PubMed2006

Pseudarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum: prevalence and risk factor analysis of 144 cases.

STUDY DESIGN: Retrospective study. OBJECTIVE: To analyze the incidence of and risk factors for pseudarthrosis in long adult spinal instrumentation and fusion to S1. SUMMARY OF BACKGROUND DATA: Few studies on pseudarthrosis in long adult spinal instrumentation and fusion to S1 exist. METHODS: A clinical and radiographic assessment of 144 adult patients with spinal deformity (average age 52.0 years; range 21.1-77.6) who underwent long (5-17 vertebrae, average 11.9) spinal instrumentation and fusion to the sacrum at a single institution between 1985 and 2002, with a minimum 2-year follow-up (average 3.9; range 2-14) was performed. RESULTS: Of 144 patients, 34 (24%) had pseudarthroses. There were 17 patients who had pseudarthroses at T10-L2 and 15 at L5-S1. A total of 24 patients (71%) presented with multiple levels involved (2-6). Pseudarthrosis was most commonly detected within 4 years postoperatively (31 patients; 94%). Factors that statistically increased the risk of pseudarthrosis were: thoracolumbar kyphosis (T10-L2 > or = 20 degrees vs. < 20 degrees, P < 0.0001); osteoarthritis of the hip joint (P = 0.002); thoracoabdominal approach (vs. paramedian approach, P = 0.009); positive sagittal balance > or = 5 cm at 8 weeks postoperatively (vs. < or = 5 cm, P = 0.012); age at surgery older than 55 years (vs. 55 years or younger, P = 0.019); and incomplete sacropelvic fixation (vs. complete sacropelvic fixation, P = 0.020). Fusion from upper thoracic spine (T2-T5) did not statistically increase the pseudarthrosis rate compared to lower thoracic spine (T9-T12) (P = 0.20). Patients with pseudarthrosis had significantly lower Scoliosis Research Society 24 outcome scores (average score 71/120) than those without (average score 90/120; P < 0.0001) at ultimate follow-up. CONCLUSION: The overall prevalence of pseudarthrosis following long adult spinal deformity instrumentation and fusion to S1 was 24%. Thoracolumbar kyphosis, osteoarthritis of the hip joint, thoracoabdominal approach (vs. paramedian approach), positive sagittal balance > or = 5 cm at 8 weeks postoperatively, older age at surgery (older than 55 years), and incomplete sacropelvic fixation significantly increased the risks of pseudarthrosis to an extent that was statistically significant. Scoliosis Research Society 24 outcomes scores at ultimate follow-up were adversely affected when pseudarthrosis developed.

Adult↗
PubMed1988

Intraosseous epidermal cyst of the sacrum. A case report.

An unusual case of intraosseous epidermal cyst is reported. The patient, a 45-year-old Japanese female, had suffered from lumbago and dysuria for about 15 years. X-ray examinations and CT scan revealed an expanded osteolytic tumor without marginal sclerotic change within the sacrum, which anteriorly invaded the surrounding soft tissues at the S2/3 level. At this time, chordoma was suspected, but epidermal cyst with foreign body granuloma was finally diagnosed from biopsy and surgical specimens.

Adult↗
PubMed1990

Intraosseous glomus tumor in the sacrum. A case report.

Primary intraosseous glomus tumor is rare and may occur in the medullary cavity of bone. A 22-year-old woman with a one-year history of spontaneous and persistent sacral pain was found to have an intraosseous glomus tumor in this unusual location. Curettage was followed by complete relief from pain. This case of glomus tumor originating in the sacrum is thought to be the first reported in the world literature.

Adult↗
PubMed1995

Malignant transformation in a fatal case of giant cell tumour of the sacrum.

Most giant cell tumours can be treated by local surgery and only rarely are they life threatening. We report a case of a giant cell tumour of the sacrum causing irresectable and fatal small bowel obstruction following malignant transformation of the tumour. The role of radiotherapy in this transformation is discussed.

Adolescent↗
PubMed1985

Insufficiency fractures of the sacrum.

Insufficiency stress fractures may occur in the sacrum after radiation therapy or secondary to postmenopausal or steroid-induced osteoporosis. These fractures are often either overlooked or confused both clinically and radiographically with metastatic disease. Findings on plain films and conventional tomograms are often subtle. Radionuclide bone scans show a characteristic distribution of increased uptake. Computed tomography is the definitive technique for demonstrating the fractures.

Adrenal Cortex Hormones↗
PubMed1993

Radiation-induced insufficiency fractures of the sacrum: evaluation with MR imaging.

In patients with malignant pelvic tumors, radiation-induced insufficiency fractures of the sacrum may be mistaken for metastasis. Magnetic resonance (MR) imaging was performed in 18 patients with this condition, and the findings were studied retrospectively. The diagnosis was confirmed with at least one additional imaging modality in 16 patients, whereas the other two patients underwent clinical follow-up at 13 and 20 months without evidence of metastasis. In 17 patients, the lesions were consistent with edema and had diffuse low signal intensity on T1-weighted images and diffuse high signal intensity on short-inversion-time inversion-recovery images, thereby simulating metastasis. In one patient, bilateral sacral wing fractures were demonstrated directly as fairly well-defined linear zones. The alae sacri were involved in all patients; 16 patients had bilateral lesions. Awareness of this clinical entity and of the high sensitivity of MR imaging for demonstrating edema caused by the fracture should prevent confusion with metastatic disease and inappropriate treatment.

Aged↗
PubMedDate not supplied

Benign fibrous histiocytoma of the sacrum--diagnostic difficulties facing this rare bone tumor.

Benign fibrous histiocytoma of bone is rare, and this is the first report of the tumor arising from the sacrum. The descriptive histopathological picture makes the diagnosis more difficult as it resembles many benign and malignant myxoid tumors. In this case report, the diagnostic difficulties involved and a review of the literature in order to describe the optimal management of this condition, have been presented. The clinical presentation of this 18-year-old girl was that of low back ache, radiating along the right posterior leg, of 1 month's duration. On the straight leg raising test, right-sided sciatic nerve compression was detected. Magnetic resonance imaging revealed a large tumor involving and destroying sacral segments S3-S4, homogeneous in intensity and extending into the vertebral canal and the presacral space. There was no enhancement with gadolinium contrast. Core needle biopsy revealed fibrous histiocytoma. Excision through a posterior midline incision was performed taking care to preserve the S1-S2 sacral segments and also the sacral nerves. Additional cauterization with phenol was performed. Postoperatively, the patient had significant improvement in pain with no major residual neurological deficit.

Adolescent↗
PubMed1995

Agenesis and dysgenesis of the sacrum: neurosurgical implications.

We reviewed 27 patients with congenital anomalies of the sacral spine. There were 16 males and 11 females with a mean follow-up of 81.1 months (range 8-211 months). Fifteen patients had sacral agenesis and 12 had sacral dysgenesis. Fifteen patients had neuroimaging of the spine. Seven patients had conus termination below the L2 vertebral body. Four patients had associated thoracic syringomyelia and 6 patients were identified with caudal or dorsal lipoma. There were only two episodes of neurological deterioration, both in a single patient who had a lipomyelomeningocele, in 182 patient-years of follow-up. Four patients with low lying conus had pre-emptive spinal cord exploration for release of tethering in order to prevent neurological deterioration. Patients with agenesis or dysgenesis of the sacrum should undergo magnetic resonance (MR) imaging of the spine in order to detect spinal cord lesions associated with progressive neurological deterioration. Findings on MR imaging are more likely to correlate with clinical course than findings on skeletal radiography.

Abnormalities, Multiple↗