bromochloroacetic-acid and Sciatica

This is a prospective study with a follow-up period of 4 years.. The study aimed to evaluate the possible clinical utility of three biomarkers [i.e., keratan sulfate (KS), hyaluronan, and cartilage oligomeric matrix protein] measured in peripheral blood in severe acute sciatica at intake and follow-up.. Our previous study and others have pointed out the interest of different laboratory tests in the acute phase of sciatica. Several blood biomarkers have been reported useful in the long-term follow-up of patients with osteoarthritis. We have found no information about the potential interest of these tests in spinal disorders.. Patients were admitted to the hospital for intensive conservative management of acute sciatica (n=82). A subgroup of patients (n=33) was selected based on the duration of symptoms at visit 1, and included those with the shortest (n=24) as well as those with the longest (n=9) duration of sciatica. Blood samples were drawn, centrifuged, and the plasma frozen. Antigenic KS, hyaluronan, and cartilage oligomeric matrix protein were measured by ELISA. Patients were re-evaluated at an average of 4.3 years (range: 2.1-6.8 years).. Thirty-three subjects with an average age of 49.2+/-10.2 years participated. At intake, levels of the three biomarkers evaluated were within the range of normal values. No significant differences were found between the results of patients with a short history of sciatica (< or =3 weeks) and those with a long duration of symptoms (>20 weeks). At follow-up, a significant increase (P<0.05) in all three biomarkers was found.. A single measurement of these three biomarker molecules does not seem to have any diagnostic or therapeutic relevance in patients with acute radicular compression. The significance of the increase in all three biomarkers after a mean follow-up of 4.3 years is unclear; it might reflect metabolic processes involved in degenerative spinal disorders. Even though we found no correlation with clinical outcome, we believe that more research is needed.

Topics: Adult; Biomarkers; Cartilage Oligomeric Matrix Protein; Enzyme-Linked Immunosorbent Assay; Extracellular Matrix; Extracellular Matrix Proteins; Female; Fibrocartilage; Follow-Up Studies; Glycoproteins; Humans; Hyaluronic Acid; Intervertebral Disc; Intervertebral Disc Displacement; Keratins; Male; Matrilin Proteins; Middle Aged; Predictive Value of Tests; Prospective Studies; Radiculopathy; Sciatica; Time Factors; Up-Regulation

This case report illustrates a patient presenting with sciatica and diagnosed with epithelioid sarcoma involving the spine.. The treatment of this patient involved multiple mass resections and decompressions of the spinal canal. Radio- and chemotherapy were applied once a clear diagnosis was obtained.. Epithelioid sarcoma is a rare tumor mainly arising in the extremities. Confusion with a benign inflammatory process are possible. Treatment after histologic diagnosis involves wide resection. To our knowledge, this report represents the first case of epithelioid sarcoma involving the spine.. After initial discectomy, recurrent scarring and mass formation required multiple decompression procedures and fusion. The initial pathology revealed inflammatory reaction on fibrosis. In a later procedure, the histologic diagnosis of epithelioid sarcoma was made. Radiotherapy and chemotherapy were begun immediately.. Despite aggressive resections, radiotherapy, and chemotherapy, the patient died 3 months after the last surgical procedure.. Spinal epithelioid sarcoma can be mistaken for a benign inflammatory process. After a histologic diagnosis, aggressive wide resection is necessary. Multiple recurrences are documented with this tumor in other sites. Prognosis in trunk involvement is less favorable than involvement of the extremities. The role of adjuvant radio- and chemotherapy is unclear for spinal involvement.

Topics: Adult; Electromyography; Humans; Keratins; Magnetic Resonance Imaging; Male; Reoperation; Sacrum; Sarcoma; Sciatica; Spinal Neoplasms; Tomography, X-Ray Computed; White People