Chataigner H, Onimus M
Service de Chirurgie des Scolioses et Orthopédie Infantile, Hôpital Saint-Jacques, Besançon.
Rev Chir Orthop Reparatrice Appar Mot. 1998 Jul;84(4):377-80.
A 42 years old patient presented with a 4 years history of a left L5 sciatica unresponsive to a previous L4-L5 surgical decompression. CT scan showed a solid tumor developed on the anterior aspect of the sacro-iliac joint, in contact with the lumbo-sacral trunk. An antero-lateral extraperitoneal approach was performed, with progressive subperitoneal dissection along the inner aspect of the iliac wing to the sacro-iliac joint and sacral ala. The exostosis was removed with "en block" excision, Postoperatively pain completely disappeared. Considerations are made on the mechanism of the compression as well as on the surgical approach performed.
一名42岁患者有4年左侧L5坐骨神经痛病史，此前L4-L5手术减压无效。CT扫描显示在骶髂关节前方出现一个实性肿瘤，与腰骶干相邻。采用腹膜外前外侧入路，沿髂骨翼内侧进行逐步的腹膜下剥离，直至骶髂关节和骶骨翼。采用“整块”切除法切除骨赘，术后疼痛完全消失。文中对压迫机制以及所采用的手术入路进行了探讨。
