Sacral Tuberculosis: Never Ignore Buttock Pain

A last few decade, case of infection with Mycobacterium tuberculosis (TB) is increasing. TB infection of other than pulmonary is quite challenging to diagnose due to non-specific signs and symptoms (Wellons III et al., 2004). Spine being the commonest site of skeletal TB which account approximately 50% from reported cases (Tuli, 2002). Spinal TB can be associated with pulmonary infection, however in less than 1% of cases, it occurs in the absence of pulmonary involvement (Davidson & Horowitz, 1970; Gorse, Pais, Kusske, & Cesario, 1983; Omari, Robertson, Nelson, & Chiu, 1989; Rezai, Lee, Cooper, Errico, & Koslow, 1995). TB infection involving the lumbosacral junction is uncommon, only 2 to 3% from all cases of spinal TB (Ahmadi, Bajaj, Destian, Segall, & Zee, 1993; Dayras, Lorilloux, Hugonet, & Benichou, 1985; MANSBERG, ROWE, & WALKER, 1991; Pun et al., 1990; Rajasekaran et al., 1998). Isolated sacral TB is rare entity, The patient usually presented with lower back pain with or without neurological involvement (Patankar et al., 2000). Here we presented a case of sacral TB which not associated with neurological impairment.

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Intramedullary Endometriosis of the Conus Medullaris

Neurosurgery ◽

10.1227/01.neu.0000223375.23617.dc ◽

2006 ◽

Vol 59 (2) ◽

pp. E428-E428 ◽

Cited By ~ 13

Author(s):

Amit Agrawal ◽

Bellore J.P. Shetty ◽

Jagadeesh H. Makannavar ◽

Lathika Shetty ◽

Jayaprakash Shetty ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Back Pain ◽

Relevant Literature ◽

Rare Condition ◽

Signs And Symptoms ◽

Conus Medullaris ◽

Resonance Imaging ◽

Acute Hemorrhage ◽

Neurological Signs ◽

Lower Back

Abstract OBJECTIVE: Intraspinal endometriosis is an extremely rare condition with characteristic symptoms, including lower back pain that increases in severity during each menstrual cycle. METHODS: Here, we report a case of endometriosis involving the conus cauda region. This patient presented with acute deterioration secondary to hemorrhage. We also review the relevant literature. RESULTS: Magnetic resonance imaging scans of the dorsolumbar region showed a mass lesion within the spinal canal at the L1–L2 level with evidence of acute hemorrhage. The patient underwent an emergency D12–L2 laminectomy and microdecompression of the lesion. The histological and immunohistochemical features were characteristic of intraspinal endometriosis. CONCLUSION: Intraspinal endometriosis must be recognized as a potential cause of periodic neurological signs and symptoms in young and middle-aged women.

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Combined Wireless Spinal Cord Stimulation, Dorsal Root Ganglion Stimulation, and Peripheral Nerve Stimulation for Treating Low Back Pain

Pain Management Case Reports ◽

10.36076/pmcr.2020/4/227 ◽

2020 ◽

pp. 227-230

Author(s):

Matthias Wiederholz

Keyword(s):

Spinal Cord ◽

Low Back Pain ◽

Back Pain ◽

Dorsal Root Ganglion ◽

Peripheral Nerve ◽

Dorsal Root ◽

Low Back ◽

Buttock Pain ◽

Pain Scores ◽

Lower Back

Background: Neuromodulation has undergone significant advances over the past decade, particularly when the DRG and PNS modalities evolved to target conditions that are hard to cover by conventional SCS. The availability of a variety of stimulation modalities allows for a customized approach. Case Presentation: A 49-year-old man presented with low back and buttock pain. The patient had a history of chronic lower back pain, L4/L5 and L5/S1 facet hypertrophy, a 3-mm left paracentral and foraminal disc protrusion minimally involving the left S1 nerve root, and right low back/buttock/hip pain after previous surgical removal of an episacroiliac lipoma on the right sacroiliac joint. Despite multiple therapies such as oral opioids, anticonvulsants, and physical therapy, the patient continued to experience right lower back and buttock pain. Conclusion: The patient’s pain scores decreased from a baseline score of 8 out of 10 without medication to a 1 out of 10 without medication. The wireless SCS and PNS significantly reduced pain scores for this patient suffering from lower back, buttock, and hip pain. Key words: Dorsal root ganglion, low back pain, peripheral nerve stimulation, spinal cord stimulation

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