1/19. sciatic neuropathy secondary to total hip arthroplasty wear debris.sciatic neuropathy after total hip arthroplasty can result from several causes. We present a case in which a large cystic mass developed around a failed total hip arthroplasty. The lesion extended through the greater sciatic notch and into the pelvis producing sciatic nerve compression. The diagnosis was delayed, and the patient underwent a laminectomy without relief of symptoms before an abdominopelvic computed tomography (CT) scan revealed the mass. After revision of the components and excision of the accessible portion of the lesion, the symptoms improved. Resolution of the intrapelvic portion of the mass was demonstrated on follow-up CT scan, suggesting that retroperitoneal resection of this type of lesion may not be required at the time of revision of the components.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/19. Idiopathic sciatic mononeuropathy.sciatic nerve lesions are usually painful and secondary to compression, trauma, infarction or part of a systemic illness. The etiology is usually defined by radiographic or blood studies, or by exploratory surgery. In rare cases, as the one being presented, there is clear clinical and electrophysiological evidence for a lesion of the sciatic nerve, but no morphological correlate or defined etiology. These idiopathic sciatic mononeuropathies seem to occur in the nerves of the legs in young adults.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
3/19. sciatic nerve compression following bone marrow harvest.We describe a donor who suffered pain secondary to sacral plexus and sciatic nerve compression post bone marrow harvest. Haematoma was demonstrated by magnetic resonance image (MRI) scanning. To our knowledge, this is the first reported case of compression neuropathy post bone marrow harvest documented by MRI scanning. Given the increasing number of bone marrow transplants being performed and the paramount importance of donor safety, compressive neuropathies need to be remembered as rare but debilitating complications of bone marrow harvesting. MRI scanning is a useful modality to investigate severe or neuropathic pain post bone marrow harvest.- - - - - - - - - - ranking = 6keywords = compression (Clic here for more details about this article) |
4/19. The value of MR neurography for evaluating extraspinal neuropathic leg pain: a pictorial essay.SUMMARY: Fifteen patients with neuropathic leg pain referable to the lumbosacral plexus or sciatic nerve underwent high-resolution MR neurography. Thirteen of the patients also underwent routine MR imaging of the lumbar segments of the spinal cord before undergoing MR neurography. Using phased-array surface coils, we performed MR neurography with T1-weighted spin-echo and fat-saturated T2-weighted fast spin-echo or fast spin-echo inversion recovery sequences, which included coronal, oblique sagittal, and/or axial views. The lumbosacral plexus and/or sciatic nerve were identified using anatomic location, fascicular morphology, and signal intensity as discriminatory criteria. None of the routine MR imaging studies of the lumbar segments of the spinal cord established the cause of the reported symptoms. Conversely, MR neurography showed a causal abnormality accounting for the clinical findings in all 15 cases. Detected anatomic abnormalities included fibrous entrapment, muscular entrapment, vascular compression, posttraumatic injury, ischemic neuropathy, neoplastic infiltration, granulomatous infiltration, neural sheath tumor, postradiation scar tissue, and hypertrophic neuropathy.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
5/19. Intraoperative positioning during cesarean as a cause of sciatic neuropathy.BACKGROUND: sciatic nerve compression has been well documented as a cause of perioperative sciatic neuropathy but rarely during cesarean. CASE: A parturient complained of left foot drop after cesarean delivery for twins performed under spinal anesthesia. Intraoperatively, her right hip was raised with padding under the right buttock to tilt the pelvis approximately 30 degrees to the left. Postoperatively, the patient had weakness, sensory changes, and diminished reflexes in the left lower extremity. Electrodiagnostic studies supported a diagnosis of neurapraxia and partial denervation in the distribution of the sciatic nerve. By postpartum week 6, she had full recovery. CONCLUSION: Elevating the right buttock during cesarean can cause compression of the underlying structures of the left buttock and result in sciatic neuropathy. Decreasing the duration of time the patient is in the left lateral position may reduce the risk of this uncommon but debilitating complication.- - - - - - - - - - ranking = 2keywords = compression (Clic here for more details about this article) |
6/19. Complete sciatic nerve palsy after open femur fracture: successful treatment with neurolysis 6 months after injury.Although relatively uncommon, peripheral nerve can be injured secondary to fracture or dislocation. As therapeutic strategies may vary with the status of the nerve involved, accurate diagnosis is critical. The case described in this report involves a complete sciatic nerve palsy occurring after an open femur fracture treated 6 months earlier. The palsy was erroneously attributed to ischemic neuropathy from compartment syndrome, but late surgical exploration showed that the sciatic nerve was in continuity but enveloped by scar. Neurolysis resulted in full motor and sensory recovery below the knee. Accurate interpretation of physical findings and neurophysiologic tests in the management of fractures associated with nerve injury is emphasized.- - - - - - - - - - ranking = 0.30310458897566keywords = fracture (Clic here for more details about this article) |
7/19. hip and pelvic fractures and sciatic nerve injury.OBJECTIVE: To investigate the influence of hip and pelvic fracture, especially acetabular fracture complicated by sciatic nerve injury on clinical features and prognosis of sciatic nerve injury. methods: From January 1987 to January 2000, 17 patients (14 male and 3 female) who had hip and pelvic fractures complicated by sciatic nerve injury were treated with operative reduction and internal fixation and followed up from 10 months to 5 years. The average age was 38 years (ranging 23-56 years). The left extremities were involved in 11 patients and the right in 6. Twelve patients underwent primary exploration and neurolysis and 5 patients underwent secondary operation. RESULTS: Preoperatively, 8 patients were treated with large doses of oral narcotics to control their severe sciatic pain. Three of the 8 patients underwent patient-controlled analgesia and epidural analgesia. After operation, excellent and good rates of reduction and functional recovery of sciatic nerve were 94.1% and 88% respectively. Four patients still had sciatic pain and 2 patients failed to recover. sciatic nerve function improved within 3-6 months after surgery in 11 patients. CONCLUSIONS: hip and pelvic fractures can result in sciatic nerve injury, especially common peroneal nerve injury and prognosis is poor. Open reduction and internal fixation combined with nerve exploration and neurolysis should be used as early as possible for severe sciatic pain.- - - - - - - - - - ranking = 0.34640524454361keywords = fracture (Clic here for more details about this article) |
8/19. The risks of overly effective postoperative epidural analgesia.Continuous epidural analgesia is frequently used to provide supplemental postoperative pain control. Epidural analgesia has the potential to mask the early symptoms that signal impending complications after even routine surgical procedures. We report a case of sciatic nerve palsy following epidural anesthesia after an uncomplicated leg length correction. Good epidural anesthesia may remove a patient's normal protective sensation, allowing pain and other signs of nerve compression from prolonged unchanged postoperative positioning to go unnoticed. This case highlights the need for heightened awareness of potential neurologic compromise in the setting of epidural analgesia. We recommend closely monitoring the patient's neurologic condition and frequently evaluating the patient's position in bed.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
9/19. Painful vascular compression syndrome of the sciatic nerve caused by gluteal varicosities.The authors report three patients with chronic sciatic pain without focal neurologic deficit. Sitting or lying on the affected side provoked pain, and standing and walking relieved it. MRI revealed varicotic gluteal vessels compressing the sciatic nerve. decompression of the nerve resulted in complete and permanent pain relief. Sciatic or buttock pain in patients with varicosities and pain provocation in the sitting or lying position suggests this neurovascular compression syndrome.- - - - - - - - - - ranking = 6keywords = compression (Clic here for more details about this article) |
10/19. Compression of the sciatic nerve by wear debris following total hip replacement: a report of three cases.pain in the distribution of the sciatic nerve is common in the elderly. In the presence of a long-standing joint replacement, consideration should be given as to whether compression might be due to an extraspinal cause. We present three women, in whom a mass of wear debris from a previous total hip replacement caused compression of the sciatic nerve posterior to the hip. The symptoms were relieved immediately following operation.- - - - - - - - - - ranking = 2keywords = compression (Clic here for more details about this article) |
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