Baba H, Okumura Y, Furusawa N, Omori H, Kawahara H, Fujita T, Katayama K, Noriki S
Department of Orthopaedic Surgery, Fukui Medical School, Japan.
Spinal Cord. 1998 Aug;36(8):584-7. doi: 10.1038/sj.sc.3100550.
We report an instructive case of a 65-year-old man who presented with a dumb-bell shaped tuberculous abscess across the greater sciatic notch bilaterally compressing both sciatic nerves. Clinical symptoms progressed slowly and mimicked lumbar radiculopathy, thus delaying an accurate diagnosis. Anterolateral retroperitoneal and posterolateral gluteal approaches of the greater sciatic notch as well as the acetabulum on both sides were followed in order to provide safe viewing and resection of the abscess. The abscess wall was adherent to the sciatic nerve and surrounding blood vessels. The symptoms completely disappeared after resection of the abscess.
我们报告了一例具有指导意义的病例,一名65岁男性,双侧坐骨大切迹处出现哑铃形结核脓肿,压迫双侧坐骨神经。临床症状进展缓慢,类似腰椎神经根病,因此延误了准确诊断。采用双侧坐骨大切迹以及髋臼的腹膜后外侧和臀后外侧入路,以便安全观察和切除脓肿。脓肿壁与坐骨神经和周围血管粘连。切除脓肿后症状完全消失。