Sacchi A, Rouaud J P, Caroit M, George B, Cophignon J
Rev Rhum Mal Osteoartic. 1982 Apr;49(5):351-4.
The authors report 3 cases of lumbar pain and sciatica where operation revealed the existence of abnormalities in the distribution of L5 and S1 roots. In one case, the L5 root was not recognised within fibrous tissue also surrounding S1 and S2 and histological examination of this "fibrosis" led to the identification of nerve structures. Development of postoperative L5 paralysis showed that the L5 root was contained within the tissue non-individualised, consisting of multiple rootlets. In the other two cases the L5 and S1 roots arose from a common trunk. There was an associated herniated disc in all three cases. A review of the literature revealed the rarity of such abnormalities, as well as the fact that they were not recognised before surgery. They are difficult to recognise, even at the time of operation. The prognosis is less good than in typical lumbar pain and sciatica, essentially because of surgical difficulties of the disc curettage.
作者报告了3例腰痛和坐骨神经痛病例,手术显示L5和S1神经根分布存在异常。其中1例,在同样包绕S1和S2的纤维组织内未识别出L5神经根,对这种“纤维化”组织进行组织学检查后发现了神经结构。术后L5麻痹的发生表明L5神经根包含在未个体化的组织内,该组织由多个小根组成。另外2例中,L5和S1神经根发自同一主干。所有3例均伴有椎间盘突出。文献回顾显示此类异常罕见,且术前未被识别。即使在手术时也难以识别。其预后比典型的腰痛和坐骨神经痛要差,主要是因为椎间盘刮除术存在手术困难。