i can only dream of the day that i can have my life back, fund raising has stalled, lifes getting rather challenging, the longer this is left untreated the more my nerves are being damaged, and more of my sacrum bone is eroding away. i try to be positive but the weight of daily chronic pain is heavy to carry mentally and physically
DATE OF BIRTH: 09/15/1977 HISTORY: I had the opportunity to interview the patient today and review her imaging studies. She is a 36-year-old woman with a history of severely symptomatic intrasacral meningeal cyst causing sacral radiculopathy symptoms. She describes sacral pain, pressure, and tenderness radiating to both buttocks and posterior thighs. She gets numbness in her left leg and foot, particularly on driving. She feels weakness in the backs of her legs. She has bladder dysfunction with slow emptying and urinary frequency. She also has bowel dysfunction with constipation requiring laxative use. Her sacral symptoms are made worse by sitting, standing, and walking and made better by lying down. Her sacral pain is such that she cannot sit for more than 5 minutes comfortably. She constantly squirms when she does sit and she avoids sitting related activities such as going to the movies, restaurant, or driving distances. Physical therapy and medications have not helped. She also underwent L5-S1 fusion, which did not help her symptoms. In fact, her surgeon now agrees that her intrasacral cyst is a primary source of her symptoms. PAST SURGICAL HISTORY: None. ILLNESS: None. MEDICATIONS: None. ALLERGIES: None. FAMILY HISTORY: No history of neurologic disease. SOCIAL HISTORY: Past tobaccoism. No history of alcohol abuse. REVIEW OF SYSTEMS: Sacral pain, difficulty sitting, bowel problems, bladder difficulties, difficulty walking, numbness and tingling. Other systems are negative. RADIOGRAPHIC FINDINGS: I reviewed the patientfs lumbosacral imaging studies. These studies reveal multiple large intrasacral meningeal cysts within the sacrospinal canal. The largest of these cysts are present on the left at S2 and on the right at S2. At the S2 level, the cysts fill almost the entire sacrospinal canal and are causing blatant compression of adjacent sacral nerve roots of the sacral cauda equina. There is no other lesion on the patientfs imaging studies other than her intrasacral cysts that would explain her symptoms. The patient states that since the date of the MRI, which I am reviewing, she has had L5-S1 fusion. I would like to see this imaging study if she does proceed with surgery. IMPRESSION: The patient is a 36-year-old woman with sacral, buttock, lower extremity, and bladder and bowel symptoms. These symptoms are consistent with a sacral radiculopathy pattern due to sacral nerve root compression within the sacrospinal canal. Imaging reveals multiple large intrasacral meningeal cysts within the sacrospinal canal causing blatant compression of adjacent sacral nerve roots of the sacral cauda equina. There is no other obvious lesion on the patientfs imaging studies other than her large intrasacral cyst that would explain her symptoms. PLAN: I discussed conservative versus surgical treatment options with the patient. I described the nature, risks, and reasonable expectations of treating her intrasacral meningeal cyst and sacral laminar reconstruction with resorbable plating. She understands all this and would like to proceed. I am a neurosurgeon specializing in spinal surgery of symptomatic spinal meningeal cyst. In particular, I specialize in the treatment of the symptomatic intrasacral cyst, such as the ones that this patient has. I am not aware of another spine surgeon in this patients part of the world, or the European Union in general with a similar experience and knowledge concerning these rare cysts. I have previously contracted with the patients and the Government of New Zealand for treatment of their patients with symptomatic intrasacral cyst. I am at this patientfs disposal to treat her pathology. * [E-SIG] _________________________ Frank Feigenbaum, M.D. FF/SN/sndovmt050/FST-16293960 D: 03/05/14
We think that our little cause can make a big difference. Thanks Annette
