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The diagnosis of sacral lesions


Surgical Neurology 15(5): 377-383
The diagnosis of sacral lesions
Clinical courses are reviewed in 4 patients with sacral lesions, each of whom on initial clinical evaluation apparently had symptomatic herniations of intervertebral discs. In each patient pain in the back tended to overshadow radicular symptoms and sphincteric disturbances were not prominent. Each patient presented some related objective abnormality on general or neurologic examination. The sacral lesion was invariably visible on technically satisfactory plain roentgenograms of the spine and was obvious on sacral tomography. Conventional myelography was useful in defining communication between the lesion and the subarachnoid space, but typically it was subtle and nonspecifically abnormal. Computed tomography (CT) was the most revealing radiographic technique, demonstrating bony detail and internal structure and extent of the lesion; in conjunction with metrizamide myelography, CT provided the most definitive anatomical study. The limited utility of angiography in diagnosing these lesions and the respective hazards and indications for needle biospy and open surgical exploration are discussed.

Accession: 006628463

PMID: 9760979

DOI: 10.1016/0090-3019(81)90176-2

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