Sciatic Nerve Compression due to Ganglion

Compression neuropathy can take place when the sciatic nerves come out from the sciatic notch and they are pressed by the nearby structure while traveling to their terminus. The common causes are the pyriformis syndrome that is caused by spasm of the pyrifomis muscle, lesions around the nerves and pressures from outside the spine. It has been occasionally reported that an intraneural ganglion develops within the sciatic nerve and this causes sciatic nerve compression. However, it has never been reported that the ganglion that developed around the nerves caused sciatic nerve compression. This case is about a 49-year-old man who underwent surgery due to the ganglion around the sciatic nerves, which had been found via a magnetic resonance image.

Kyphoplasty with Calcium Phosphate Cement (Calcibon(R)) in Osteoporotic Vertebral Fracture / 대한척추외과학회지

STUDY DESIGN: A retrospective study OBJECTIVES: We analyzed clinical and radiological results to verify the efficacy of calcium phosphate cement in kyphoplasty for treatment of osteoporotic vertebral fracture. SUMMARY AND LITERATURE REVIEW: Calcium phosphate is a biocompatible alternative to PMMA for vertebral augmentation in painful osteoporotic vertebral fracture as it is osteoconductive, non-exothermic, and injectable. MATERIALS AND METHODS: We analyzed 45 cases treated from April 2005 to August 2006 with a minimum of 1 year follow-up. Preoperative and post operative pain scores (visual analogue scale), ambulatory status, and patient satisfaction were measured. Anterior vertebral height, as well as the status and size of cement were assessed radiologically preoperatively, postoperatively, and at 3 months and 1 year. RESULTS: Pain scores (visual analogue scale) and ambulatory status improved significantly after kyphoplasty and remained unchanged during follow-up. Overall patient satisfaction was 93%. Radiological findings showed that mean vertebral height was significantly higher than preoperative (p<0.05). According to follow-up radiological finding, we divided cases into 4 groups: Group 1, 2; maintained vertebral height with minimal or some cement resorption; Group 3, 4; cement crack resorption and vertebral collapse. Group 1, 2 and Group 3, 4 had 38 patients (84%) and 7 patients(16%) respectively. Revision surgery was needed in 3 cases (antero-posterior surgery in 2 cases of group 4, and decompression in 1 case of extravasation into the neural canal). CONCLUSIONS: Kyphoplasty with calcium phosphate may be a good alternative for treatment of osteoporotic vertebral fracture, but non-union of the vertebral body with a large cleft showed a high risk of premature resorption and collapse of the vertebral body. The presumed advantage over PMMA needs longer follow-up.