联合神经根、硬膜外静脉曲张和腰椎间盘突出：难治性坐骨神经痛三联征。
Conjoined nerve root, epidural varicose vein, and extruded lumbar disc: Triad of refractory sciatica.
作者信息
Ahmed Nazmin, Hossain Mohammad Nazrul, Khan Shahidul Islam, Kazi Raad
机构信息
Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute (A Centre for Cardiovascular, Neuroscience and Organ Transplant Units), Dhaka, Bangladesh.
Department of Orthopedic Surgery, Bangladesh Medical University, Dhaka, Bangladesh.
出版信息
Surg Neurol Int. 2025 May 23;16:200. doi: 10.25259/SNI_371_2025. eCollection 2025.
BACKGROUND
A patient presented with sciatica attributed to a conjoined lumbosacral nerve root, an extruded disc herniation, and epidural varicose veins.
CASE DESCRIPTION
A 60-year-old male presented with 5 months of sciatica (4/5 motor deficit). The lumbosacral magnetic resonance showed a right paracentral disc herniation causing thecal sac/L5-S1 nerve root compression. Intraoperatively, the patient had an L5-S1 conjoined nerve root, an extruded disc herniation, and type C epidural varicose veins. A wide fenestration and foraminotomy were performed to facilitate the removal of the extruded disc and partial coagulation of the epidural varicose veins. Surgery resulted in complete symptom resolution within the 1 postoperative month.
CONCLUSION
A patient with intractable right-sided sciatic was found at surgery to have an L5-S1 conjoined nerve root, a herniated disc, and marked epidural varicosities. Following a wide fenestration/foraminal decompression, the patient's symptoms fully resolved within the 1 postoperative month.
背景
一名患者因腰骶神经根联合、椎间盘突出及硬膜外静脉曲张出现坐骨神经痛。
病例描述
一名60岁男性，出现坐骨神经痛5个月（运动功能障碍4/5级）。腰骶部磁共振成像显示右侧中央旁型椎间盘突出，压迫硬脊膜囊/L5 - S1神经根。术中发现患者存在L5 - S1神经根联合、椎间盘突出及C型硬膜外静脉曲张。进行了广泛开窗和椎间孔切开术，以利于摘除突出的椎间盘并对硬膜外静脉曲张进行部分凝固。手术使患者在术后1个月内症状完全缓解。
结论
一名患有顽固性右侧坐骨神经痛的患者在手术中被发现存在L5 - S1神经根联合、椎间盘突出及明显的硬膜外静脉曲张。经过广泛开窗/椎间孔减压后，患者症状在术后1个月内完全缓解。
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