Ergin Atilla, Toker Tansel, Yanarates Omer, Kurt Ercan, Guzeldemir M Erdal
Gulhane Military Medical Faculty, Department of Anesthesiology and Reanimation, Ankara, Turkey.
Reg Anesth Pain Med. 2007 Jan-Feb;32(1):89-92. doi: 10.1016/j.rapm.2006.09.008.
Pain arising in the lumbar spine can have many etiologies, nearly 80% of which cannot be established with certainty. We present a very rare cause of back pain.
A 54-year-old woman presented with a 2-month history of low-back pain and right-sided sciatica. Conventional analgesics, physiotherapy, and epidural steroid application had failed to provide relief. She had tenderness of the right sacroiliac joint. Diagnostic fluoroscopic-guided sacroiliac-joint injection with lidocaine did not produce symptomatic relief. Pelvic ultrasonography and magnetic resonance imaging showed septated multilocular hydatic cysts along the sciatic nerve. Surgical exploration noted multicystic lesions along the sciatic nerve woven to the nerve. Her low-back pain disappeared completely after the operation. She received oral albendazole for 6 months to prevent any recurrence of the disease and remains asymptomatic.
Hydatid cyst can be included in the differential diagnosis of lumbar back pain, especially in the endemic areas.
腰椎疼痛可能有多种病因，其中近80%无法明确诊断。我们报告一例非常罕见的背痛病因。
一名54岁女性，有2个月的下背痛和右侧坐骨神经痛病史。常规镇痛药、物理治疗和硬膜外注射类固醇均未能缓解疼痛。她右侧骶髂关节有压痛。在透视引导下向骶髂关节注射利多卡因进行诊断性治疗，症状未缓解。盆腔超声和磁共振成像显示沿坐骨神经有分隔的多房性棘球蚴囊肿。手术探查发现沿坐骨神经有多个囊肿样病变并与神经交织。术后她的下背痛完全消失。她接受了6个月的阿苯达唑口服治疗以预防疾病复发，目前仍无症状。
棘球蚴囊肿应纳入腰痛的鉴别诊断，尤其是在流行地区。
