INTRODUCTION Sacral insufficiency fractures are an important cause of lower back pain in the elderly. Clinically and radiologically, they must be distinguished from osseous metastases, which frequently coexist. To date, no case report has comprehensively explored the full range of diagnostic hurdles and potential pitfalls. CASE PRESENTATION We report the case of a 70-year-old Caucasian female...

Unstable pelvic ring fractures raise treatment challenges in severely injured patients. Ilio-sacral screw fixation is an elegant option for stabilising the posterior lesion, which is a common source of residual pain. This technique provides secure fixation. The first description can be found in a 1913 treatise by Lambotte [1]. In 1978, Letournel reported the treatment of sacro-iliac joint dislo...

It is unclear if a decrease in cancellous bone density or cortical bone thickness is related to sacral insufficiency fractures. We hypothesized that reduction in overall bone density leads to local reductions in bone density and cortical thickness in cadaveric sacra that match clinically observed fracture patterns in patients with sacral insufficiency fractures. We used quantitative computed to...

Perineurial cysts (Tarlov cysts) are lesions of the nerve root that are often observed in the sacral area. There is debate about whether symptomatic perineurial cysts should be treated surgically. We presented three patients with symptomatic perineurial cyst who were treated surgically, and introduced sacral recapping laminectomy. Patients complained of low back pain and hypesthesia on lower ex...

Lumbosacral osteomyelitis and discitis are usually a result of hematogenous spread; rarely it can result from direct inoculation during a surgical procedure. Bacteria may also track along implanted devices to a different location. This is a rare complication seen from pelvic organ prolapse surgery with sacral colpopexy. A 67-year-old female developed increasing lower back pain four months follo...

A 76-year-old man presented with a Denis Zone III sacral fracture after a traffic accident. He also developed urinary retention and perineal numbness. The patient was diagnosed with neurogenic bladder dysfunction caused by the sacral fracture. A computed tomogram (CT) revealed that third sacral lamina was fractured and displaced into the spinal canal, but vertebral body did not displace. The fr...

Previous work of our laboratory has shown that neurons in the lateral sacral cord in cat project heavily to the periaqueductal gray (PAG), in all likelihood conveying information from bladder and genital organs. In humans this information usually does not reach consciousness, which raises the question of whether the lateral sacral cell group projects to the thalamus. After wheatgerm agglutinin-...

404 CMYK Sir, An anterior sacral meningocele is a cerebrospinal fluid-filled unilocular or multilocular extension of the duramater and arachnoid mater out of the spinal canal through a defect either in the anterior sacral wall or antero-laterally through an enlarged vertebral foramen or coalesced foramina into the pelvic retroperitoneal and infraperitoneal space. Since its description by Bryant...

Neuroprosthetic techniques have been used to facilitate voiding via electrical stimulation for bladder management following spinal cord injury (SCI), but high urethral resistance has been a problem. This problem was investigated here in the chronic, spinal, male cat (C6-T1) using direct bladder and sacral nerve stimulation. Direct bladder stimulation was only conducted during terminal procedure...

Sacral insufficiency fractures are a more commonly recognized cause of spine pain among osteoporotic patients, and are now treatable by sacroplasty using percutaneous instillation of PMMA cement. Sacroplasty may be performed using only fluoroscopic landmarks; however, the bony anatomy of the sacrum is complex and the cement deposition based on these landmarks has not been specifically confirmed...