Superior gluteal vein syndrome: an intrapelvic cause of sciatica
Autor: | Kinshuk Kumar, Adrienne L K Li, Manoel João Batista Castello Girão, Renato Moretti Marques, Nucelio Lemos, Laura Cancelliere, Corey Sermer, Gustavo L Fernandes, Jose Sebastiao Afonso |
---|---|
Rok vydání: | 2019 |
Předmět: |
musculoskeletal diseases
Sciatica 030222 orthopedics Plexus medicine.medical_specialty business.industry Decompression Pelvic pain Neurovascular bundle Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure medicine.vein Superior gluteal veins medicine medicine.symptom business Research Articles 030217 neurology & neurosurgery Pelvis Lumbosacral joint |
Zdroj: | Journal of Hip Preservation Surgery |
ISSN: | 2054-8397 |
DOI: | 10.1093/jhps/hnz012 |
Popis: | The role of malformed or dilated branches of iliac vessels in causing pelvic pain is not well understood. Such vessels may entrap nerves of the lumbosacral (LS) plexus against the pelvic sidewalls, producing symptoms not typically encountered in gynecological practice, including sciatica and refractory urinary and/or anorectal dysfunction. We describe cases of sciatica in which laparoscopy revealed compression of the LS plexus by variant superior gluteal veins (SGVs). In demonstrating an improvement in patient symptoms after decompression, we identify this neurovascular conflict as a potential intrapelvic cause of sciatica. This study is a retrospective case series (Canadian Task Force Classification II-3). Nerve decompression laparoscopies were performed in São Paulo, Brazil. Thirteen female patients undergoing laparoscopy for sciatica with no clear spinal or musculoskeletal causes were included in this study. In all cases, we identified LS entrapment by aberrant SGVs, and performed decompression by vessel ligation. The average preoperative visual analog scale score of 9.62 ± 0.77 decreased significantly to 2.54 ± 2.88 post-operatively (P < 0.001). The success rate (defined as ≥ 50% improvement in visual analog scale score) was 92.3%, over a follow-up of 13.2 ± 10.6 months. Our case series demonstrates a high success rate and significant decrease in pain scores after laparoscopic intrapelvic decompression, thereby identifying pelvic nerve entrapment by aberrant SGVs as a potential yet previously unrecognized cause of sciatica. This intrapelvic neurovascular conflict—the SGV syndrome—should be considered in cases of sciatica with no identifiable spinal or musculoskeletal etiology. |
Databáze: | OpenAIRE |
Externí odkaz: |