A Rare Case of Partially Ossified Sacrospinous Ligament Causing Sciatic Nerve Compression.

Mymensingh medical journal : MMJ Pub Date : 2024-10-01
R K Shams, M Khan, A Islam, M C Das, U Chowdhury, D Das
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Abstract

Ossification of sacrospinous ligament induces a great risk for maintaining the stability of the pelvis. The sacrospinous ligament, along with the sacrotuberous ligament, plays a distinct role in the sacroiliac joint and pubic symphysis stability. The ossification may cause compression of neurovascular structure traversing through the greater and lesser sciatic foramen. Here we report a case of unilateral heterogenous ossification of the left sacrospinous ligament causing sciatic nerve compression and sciatic pain. A 22-year-old Bangladeshi woman, mother of one child, presented with complaints of pain in the lower back, left buttock and back of the upper thigh. Clinical examination and investigations revealed a diagnosis of the partially ossified sacrospinous ligament with sciatic nerve compression. Total excision of heterotrophic calcification and partial excision of left sacrospinous ligament through posterior approach by a left paramedian incision over the lower back was performed under general anaesthesia. On outpatient follow-up visits at 2 weeks and 6 weeks post-surgery, complete disappearance of pain was observed, and the patient was able to return to regular productive life activity. In this report, we presented a rare case of ossified sacrospinous ligament causing sciatic nerve compression with unknown etiology. The surgical approach performed, total excision of heterotrophic calcification and partial excision of left sacrospinous ligament through the posterior approach helped to preserve the pelvic stability with a good clinical outcome.

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骶棘韧带部分骨化导致坐骨神经受压的罕见病例
骶棘韧带的骨化对保持骨盆的稳定性有很大风险。骶棘韧带和骶骨韧带在骶髂关节和耻骨联合的稳定性方面发挥着独特的作用。骨化可能会压迫穿过坐骨大孔和坐骨小孔的神经血管结构。在此,我们报告了一例左侧骶棘韧带单侧异源性骨化导致坐骨神经受压和坐骨神经痛的病例。一名 22 岁的孟加拉妇女是一个孩子的母亲,主诉下背部、左臀部和大腿后侧疼痛。临床检查和化验结果显示,她被诊断为骶棘韧带部分骨化并伴有坐骨神经压迫。在全身麻醉的情况下,通过腰部左侧骨旁切口的后方入路,对异质钙化进行了全切除,并对左侧骶棘韧带进行了部分切除。术后 2 周和 6 周的门诊随访观察到疼痛完全消失,患者能够恢复正常的生产生活活动。在本报告中,我们介绍了一例病因不明的骶棘韧带骨化导致坐骨神经受压的罕见病例。我们采用的手术方法是通过后方入路完全切除异位钙化和部分切除左侧骶棘韧带,这有助于保持骨盆的稳定性,并取得了良好的临床效果。
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