Shimoda Yusuke, Morimoto Daijiro, Isu Toyohiko, Motegi Hiroaki, Imai Tetsuaki, Matsumoto Ryouji, Isobe Masanori, Kim Kyongsong, Sugawara Atsushi
Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
No Shinkei Geka. 2010 Nov;38(11):1025-30.
A 75-year-old male presented with groin pain after an operation to treat lumbar spondylolisthesis (L5). Groin tenderness was localized to the medial border of the anterior superior iliac spine (ASIS). Radiographical and physical examination raised the suspicion of sacroiliac joint (SIJ) dysfunction. Injection of a painkiller into the SIJ relieved symptoms, including groin tenderness. Symptoms improved gradually, and finally disappeared after five SIJ injections. Groin pain has been reported as a referred symptom of SIJ dysfunction in 9.3-23% of patients. Prior to the patient undergoing surgery to treat lumbar spondylolisthesis, SIJ dysfunction had not been noted on physical examination. Long periods spent in the abnormal posture due to lumbar spondylolisthesis induced SIJ stress. After the operation, an improvement in daily activity actually increased stress on the SIJ, resulting in SIJ dysfunction. Certain pathologies, including SIJ dysfunction, should be considered as residual symptoms after operations for lumbar spinal diseases.
一名75岁男性在接受治疗腰椎滑脱（L5）的手术后出现腹股沟疼痛。腹股沟压痛局限于髂前上棘（ASIS）内侧缘。影像学和体格检查引发了对骶髂关节（SIJ）功能障碍的怀疑。向骶髂关节注射止痛剂缓解了症状，包括腹股沟压痛。症状逐渐改善，在进行五次骶髂关节注射后最终消失。据报道，9.3%至23%的患者中，腹股沟疼痛是骶髂关节功能障碍的牵涉性症状。在该患者接受治疗腰椎滑脱的手术之前，体格检查未发现骶髂关节功能障碍。由于腰椎滑脱导致长时间处于异常姿势，引发了骶髂关节压力。手术后，日常活动的改善实际上增加了骶髂关节的压力，导致骶髂关节功能障碍。某些病症，包括骶髂关节功能障碍，应被视为腰椎疾病手术后的残留症状。
