Hu Ming-Hsiao, Wu Kuan-Wen, Jian Yu-Ming, Wang Chen-Ti, Wu I-Hui, Yang Shu-Hua
Department of Orthopaedic Surgery, National Taiwan University Hospital, Yun-lin Branch, Douliou City, Yunlin County, Taiwan, Republic of China.
Ann Vasc Surg. 2010 Nov;24(8):1134.e1-4. doi: 10.1016/j.avsg.2010.02.043. Epub 2010 May 15.
Sciatica is defined as pain or discomfort along the regions innervated by the sciatic nerve. Compression or irritation of lumbar spinal roots, most commonly because of lumbar disc herniation or spinal stenosis, causes sciatica in the vast majority of cases. Although it is rather uncommon, many pathologies have reported to cause nondiscogenic sciatica. A 70-year-old woman presented with intractable sciatic pain which was not elicited by posture change or cough. Sitting on the affected side provoked more pain than standing or walking. Magnetic resonance imaging revealed both spondylolisthesis with lumbar stenosis and compression of the gluteal portion of the sciatic nerve by varicotic gluteal veins. Given the atypical presentation of spinal root compression, gluteal vascular compressive neuropathy was suspected. Ligation and resection of varicotic vein resulted in relief of the patient's pain. To our knowledge, cases with varicosity-caused sciatica were limited in the literature review.
坐骨神经痛被定义为沿坐骨神经所支配区域的疼痛或不适。在绝大多数情况下，腰椎神经根受压或受刺激，最常见的原因是腰椎间盘突出症或椎管狭窄，会导致坐骨神经痛。虽然相当罕见，但许多病理情况已被报道可引起非椎间盘源性坐骨神经痛。一名70岁女性出现顽固性坐骨神经痛，姿势改变或咳嗽均未诱发疼痛。患侧坐着比站立或行走引发更多疼痛。磁共振成像显示既有腰椎滑脱伴腰椎管狭窄，又有曲张的臀静脉对坐骨神经臀段的压迫。鉴于神经根受压的非典型表现，怀疑为臀血管压迫性神经病变。曲张静脉结扎和切除使患者疼痛缓解。据我们所知，文献综述中由静脉曲张引起坐骨神经痛的病例有限。
