Shields R E, Aaron J O, Postel G, Gaar E, Hourigan J
Department of Diagnostic Radiology, University of Louisville Hospital, KY 40292, USA.
J Ky Med Assoc. 1997 Jul;95(7):268-70.
Lower extremity radiculopathy usually originates from abnormal changes in the spinal canal, such as herniated nucleus pulposus, degenerative spinal stenosis, or spondylolisthesis. Multiple cases have been reported in which lower extremity neurologic symptoms were associated with a vascular abnormality in the abdomen or pelvis. Femoral and obturator neuropathies and lumbosacral radiculopathies have been described as presenting signs of complicated aortic and iliac aneurysms. We present an unusual case of a nonruptured aortoiliac aneurysm with erosion into the spinal canal and neuroforamina which presented as a lumbosacral radiculopathy secondary to direct compression of nerve roots. The unsuspected presence of a major vascular structure in an atypical location could have catastrophic consequences in the fact of instrumentation. In patients with known or suspected aortoiliac aneurysms, CT or MRI evaluation of the spine should be performed as the initial diagnostic evaluation of new radicular pain.
下肢神经根病通常源于椎管的异常变化，如髓核突出、退行性脊柱狭窄或椎体滑脱。已有多例报道称下肢神经症状与腹部或骨盆的血管异常有关。股神经和闭孔神经病变以及腰骶神经根病已被描述为复杂性主动脉和髂动脉瘤的表现体征。我们报告了一例罕见病例，一个未破裂的主髂动脉瘤侵蚀至椎管和神经孔，表现为因神经根直接受压继发的腰骶神经根病。在进行器械操作时，非典型位置未被怀疑存在的主要血管结构可能会带来灾难性后果。对于已知或疑似主髂动脉瘤的患者，脊柱CT或MRI评估应作为新发神经根性疼痛的初始诊断评估。
