Jacquot J M, Finiels H, Fardjad S, Belhassen S, Leroux J L, Pelissier J
Department of Physical Medicine and Rehabilitation, Caremeau Teaching Hospital, Nîmes, France.
Rev Rhum Engl Ed. 1999 Feb;66(2):109-14.
Three cases of nerve root compromise in elderly women with insufficiency fractures of the sacrum are reported. Neurological compromise is generally felt to be exceedingly rare in this setting. A review of 493 cases of sacral insufficiency fractures reported in the literature suggested an incidence of about 2%. The true incidence is probably higher since many case-reports provided only scant information on symptoms; furthermore, sphincter dysfunction and lower limb paresthesia were the most common symptoms and can readily be overlooked or misinterpreted in elderly patients with multiple health problems. The neurological manifestations were delayed in some cases. A full recovery was the rule. The characteristics of the sacral fracture were not consistently related with the risk of neurological compromise. In most cases there was no displacement and in many the foramina were not involved. The pathophysiology of the neurological manifestations remains unclear. We suggest that patients with sacral insufficiency fractures should be carefully monitored for neurological manifestations.
本文报告了3例老年女性骶骨不全骨折伴神经根受压的病例。一般认为，在这种情况下神经功能受损极为罕见。对文献报道的493例骶骨不全骨折病例进行回顾，发现其发生率约为2%。实际发生率可能更高，因为许多病例报告仅提供了关于症状的少量信息；此外，括约肌功能障碍和下肢感觉异常是最常见的症状，在患有多种健康问题的老年患者中很容易被忽视或误解。部分病例的神经症状出现延迟。通常可完全恢复。骶骨骨折的特征与神经功能受损风险之间并无一致的关联。大多数病例无移位，许多病例的椎间孔未受累。神经症状的病理生理学机制尚不清楚。我们建议，对于骶骨不全骨折患者，应密切监测其神经症状。
