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Intrapelvic Nerve Entrapment Syndrome Caused by a Variation of the Intrapelvic Piriformis Muscle and Abnormal Varicose Vessels: A Case Report

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초록

Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are often overlooked by physicians. Laparoscopic surgical interventions for nerve entrapment syndromes of the posterior pelvis focus on removing the compression lesion with the purpose of eliminating the suspected cause of sciatica, as well as pudendal neuralgia. Herein, the authors report the rare event of sciatic and pudendal nerve entrapment, which was caused by aberrant vessels and a variant piriformis muscle bundle, as a seldom-diagnosed cause of sciatica and pelvic pain, for both neurosurgeons and neuropelveologists. The authors present the laparoscopic decompression technique for the pudendal and sciatic nerves by giving our technical “tips and tricks” enriched by a surgical video.

Abstract

Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are often overlooked by physicians. Laparoscopic surgical interventions for nerve entrapment syndromes of the posterior pelvis focus on removing the compression lesion with the purpose of eliminating the suspected cause of sciatica, as well as pudendal neuralgia. Herein, the authors report the rare event of sciatic and pudendal nerve entrapment, which was caused by aberrant vessels and a variant piriformis muscle bundle, as a seldom-diagnosed cause of sciatica and pelvic pain, for both neurosurgeons and neuropelveologists. The authors present the laparoscopic decompression technique for the pudendal and sciatic nerves by giving our technical “tips and tricks” enriched by a surgical video.

참고문헌 (10)

  1. Possover M, "Pelvic neuralgias by neuro-vascular entrapment : anatomical findings in a series of 97 consecutive patients treated by laparoscopic nerve decompression", Pain Physician, 18, pp.E1139~E1143 (2015)
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  3. Possover M, "Laparoscopic therapy for endometriosis and vascular entrapment of sacral plexus", Fertil Steril, 95, pp.756~758 (2011)
  4. Lemos N, "Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms", Int Urogynecol J, 27, pp.317~319 (2016)
  5. Kale A, "Vascular entrapment of both the sciatic and pudendal nerve causing persistent sciatica and pudendal neuralgia", J Minim Invasive Gynecol, 26, pp.360~361 (2018)
  6. Al-Khodairy AWT, "Sciatica in the female patient:anatomical considerations, aetiology and review of the literature", Eur Spine J, 16, pp.721~731 (2007)
  7. Kulcu DG, "Differential diagnosis of intraspinal and extraspinal non-discogenic sciatica", J Clin Neurosci, 15, pp.1246~1252 (2008)
  8. Natsis K, "Anatomical variations between the sciatic nerve and the piriformis muscle : a contribution to surgical anatomy in piriformis syndrome", Surg Radiol Anat, 36, pp.273~280 (2014)
  9. 한석구, "Surgical Treatment of Piriformis Syndrome", Clinics in Orthopedic Surgery, 9(2), pp.136~144 (2017), 대한정형외과학회
  10. Lemos N, "Laparoscopic approach to intrapelvic nerve entrapments", J Hip Preserv Surg, 2, pp.92~98 (2015)

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