Related Experiment Videos
The diagnosis of sacral lesions
M G Luken1, W J Michelsen, M A Whelan
1Department of Neurosurgery, Neurological Institute of New York, NY, USA.
Surgical Neurology
|May 1, 1981
Summary
Sacral lesions can mimic herniated discs, presenting with back pain and neurological signs. Advanced imaging like CT scans is crucial for accurate diagnosis of these rare spinal conditions.
Area of Science:
- Neurology
- Radiology
- Spinal Surgery
Background:
- Sacral lesions are rare and can be misdiagnosed as common spinal conditions.
- Differentiating sacral lesions from intervertebral disc herniations is clinically challenging.
Observation:
- Four patients initially diagnosed with symptomatic herniated intervertebral discs were found to have sacral lesions.
- Key clinical features included predominant back pain over radicular symptoms and subtle neurological deficits.
- Objective abnormalities were noted on general or neurological examination.
Findings:
- Sacral lesions were visible on plain roentgenograms and sacral tomography.
- Conventional myelography showed subarachnoid space communication but was otherwise nonspecific.
- Computerized tomography (CT) combined with metrizamide myelography provided definitive anatomical detail.
Implications:
- CT imaging is essential for characterizing sacral lesions.
- Accurate diagnosis requires considering sacral lesions in the differential for back pain with neurological findings.
- The study discusses the utility of angiography, needle biopsy, and surgical exploration for these lesions.