Radiation-induced lumbosacral plexopathy and pelvic insufficiency fracture: A case report of unique coexistence of complications after radiotherapy for prostate cancer.

Case reports of plexopathy after prostate cancer are usually neoplastic. Radiation-induced lumbosacral plexopathy and insufficiency fractures have clinical significance due to the need to differentiate them from tumoral invasions, metastases, and spinal pathologies. Certain nuances, including clinical presentation and screening methods, help distinguish radiation-induced plexopathy from tumoral plexopathy. This case report highlights the coexistence of these two rare clinical conditions. Herein, we present a 78-year-old male with a history of radiotherapy for prostate cancer who developed right foot drop, severe lower back and right groin pain, difficulty in standing up and walking, and tingling in both legs over the past month during remission. The diagnosis of lumbosacral plexopathy and pelvic insufficiency fracture was made based on magnetic resonance imaging, positron emission tomography, and electroneuromyography. The patient received conservative symptomatic treatment and was discharged with the use of a cane for mobility. Radiation-induced lumbosacral plexopathy following prostate cancer should be kept in mind in patients with neurological disorders of the lower limbs. Pelvic insufficiency fracture should also be considered if the pain does not correspond to the clinical findings of plexopathy. These two pathologies, which can be challenging to diagnose, may require surgical or complex management approaches. However, in this patient, conservative therapies led to an improvement in quality of life and a reduction in the burden of illness.

Impact of Cataract Surgery on Functional Balance Skills of Adults

Objectives: To investigate the impact of phacoemulsification surgery and intraocular lens implantation on the functional balance skills of adults. Materials and Methods: This prospective study included patients with cataract who were recommended phacoemulsification surgery and intraocular lens implantation between May and October 2016. The Berg Balance Scale and Tinetti Gait and Balance Test were performed by a physical therapy specialist before and 1 month after surgery. Patients were analyzed in terms of age, visual acuity, and balance. Balance scores before and after cataract surgery were compared. We also compared patients with high (≤2 LogMAR) and low (>2 LogMAR) visual acuity. P values below 0.05 were accepted as statistically significant. Results: Fifty-one patients (27 female and 24 male, mean age 66.96 years) were included in the study. One month after surgery, the patients' Berg Balance scores and Tinetti Gait and Balance scores were increased by 3.60±5.00% and 4.14±6.55%, respectively. Postoperative increase in visual acuity was significantly greater in the 16 patients with visual acuity less than 0.05 (>2 LogMAR) (p=0.036), but balance scores were not significantly different. Conclusion: Visual acuity is significantly improved one month after cataract surgery, which also leads to significant increases in low functional balance scores among patients with poorer vision. The rapid increase in vision after cataract surgery enhances balance skills, resulting in safer mobility and increased quality of life.