Kaplan J L, Challenor Y
Department of Physical Medicine & Rehabilitation, Columbia University College of Physicians and Surgeons, New York, NY.
Arch Phys Med Rehabil. 1993 May;74(5):552-4. doi: 10.1016/0003-9993(93)90124-s.
Sciatic nerve entrapment in an osseous tunnel has only been reported twice previously. We describe a 19-year-old man evaluated for left lower limb pain and weakness that began one and one half years after sustaining stab wounds to the left buttock and midline back near the T11 vertebrae. The patient had sciatica and demonstrated motor and sensory deficits on physical exam. Electrodiagnostic studies demonstrated a localized injury to the sciatic nerve in the proximal thigh. Radiographic studies of the left pelvis and femur showed an 8 to 10cm linear opacification overshadowing the left femoral head and anatomic neck. An arteriogram of the left leg demonstrated a 3 x 4cm lobulated aneurysm arising from the distal portion of the inferior gluteal artery. Surgical exploration revealed the sciatic nerve to be encased in cylindrical bone. The ectopic bone was removed and the sciatic nerve released. The patient had gradual improvement with a nearly complete neurological recovery by three months after surgery.
坐骨神经在骨性隧道内受压此前仅被报道过两次。我们描述了一名19岁男性，因左下肢疼痛和无力前来就诊，症状始于其左臀部和T11椎体附近背部中线遭受刺伤一年半后。患者患有坐骨神经痛，体格检查显示有运动和感觉功能障碍。电诊断研究表明大腿近端的坐骨神经存在局部损伤。左骨盆和股骨的影像学检查显示一条8至10厘米的线性致密影遮盖了左股骨头和解剖颈。左腿动脉造影显示臀下动脉远端有一个3×4厘米的分叶状动脉瘤。手术探查发现坐骨神经被包在圆柱形骨内。异位骨被移除，坐骨神经得以松解。患者术后逐渐好转，术后三个月时神经功能几乎完全恢复。
