RESUMO
Tarlov cysts are a common finding in MRI. Most of them are asymptomatic but in some cases can cause pain in urogenital region. Diagnosis and treatment are controversial and most of the symptomatic cases are not well diagnosed and treated because of unawareness of neurosurgeons about them. Treatment of symptomatic TC is effective and good results have been published with percutaneous and surgical techniques. A case of a young woman with a symptomatic sacral cyst treated surgically successfully is presented and literature about it is reviewed.
Assuntos
Cistos de Tarlov , Feminino , Humanos , Cistos de Tarlov/diagnóstico , Cistos de Tarlov/cirurgia , Dor/cirurgia , Laminectomia/métodos , Microcirurgia/métodos , SacroRESUMO
Different interventional procedures performed under imaging guidance permit the diagnosis and treatment of the many causes of back pain. Sources of pain amenable to be treated include facet joints, vertebral body, intervertebral disk, and paraspinal structures including nerves and ganglion roots. These procedures may be merely diagnostic, therapeutic, or intended for both purposes. We review the main indications, advantages, and complications of these techniques.
Assuntos
Coluna Vertebral/cirurgia , Técnicas de Ablação , Dor nas Costas/terapia , Biópsia por Agulha , Descompressão Cirúrgica , Drenagem , Fluoroscopia , Glucocorticoides/administração & dosagem , Humanos , Injeções Intra-Articulares , Disco Intervertebral/patologia , Disco Intervertebral/cirurgia , Cifoplastia , Mielografia , Bloqueio Nervoso , Neuralgia/terapia , Radiografia Intervencionista , Neoplasias da Coluna Vertebral/cirurgia , Coluna Vertebral/patologia , Vertebroplastia , Articulação ZigapofisáriaRESUMO
PURPOSE: The aim of this study was to compare the effectiveness of percutaneous vertebroplasty and kyphoplasty to treat pain from non-neoplastic vertebral fractures and improve functional outcomes. MATERIALS AND METHODS: We compared 30 patients treated by vertebroplasty for non-neoplastic vertebral fractures with 30 patients treated by kyphoplasty for the same condition. Pain was measured with a visual analogue scale (VAS) and functional outcome with the Oswestry disability index (ODI). Baseline data were compared with measurements on the day after the procedure (for pain alone) and at 1 month, 6 months, and 1 year. RESULTS: The VAS pain score was reduced by 4-5 points on the day after either type of treatment, a statistically significant improvement. The global ODI was significantly improved (by 13-18 points) at 1 month after either procedure. These improvements persisted at 6 months and 1 year. No significant differences in functional outcome were observed between the techniques. CONCLUSION: Vertebroplasty and kyphoplasty obtain similar improvements in pain and functional outcomes in these patients. The choice of technique must therefore depend on other factors. An initial improvement with either technique is a good predictor of long-term improvement.
Assuntos
Fraturas Espontâneas/terapia , Cifoplastia , Osteoporose/complicações , Dor Pós-Operatória/diagnóstico , Fraturas da Coluna Vertebral/terapia , Vertebroplastia , Atividades Cotidianas , Idoso , Feminino , Fraturas Espontâneas/etiologia , Humanos , Cifoplastia/instrumentação , Cifoplastia/métodos , Imagem por Ressonância Magnética Intervencionista , Masculino , Medição da Dor , Vertebroplastia/instrumentação , Vertebroplastia/métodosRESUMO
PURPOSE: To compare clinical and computed tomography (CT) measures in extension, 20 degrees and 30 degrees of flexion of symptomatic knees of patient with idiopathic patellofemoral pain syndrome with the contra lateral asymptomatic knee. MATERIALS AND METHODS: Knees of 52 consecutive patients with idiopathic patellofemoral pain were studied with CT. In 28 patients this condition was unilateral and asymptomatic knee was used as control; 76 knees were symptomatic. RESULTS: In patients with idiopathic patellofemoral pain we found a greater Q angle and internal condylar facet width in symptomatic knees with regard to asymptomatic knees. CONCLUSION: Greater Q angle and medial condylar facet can lead to overpressure on the medial knee compartment during maneuvers that increase contact between patella and medial condylar facet, such as knee flexion and squatting, contributing to development of idiopathic patellofemoral pain.
