Sciatica in the female patient: anatomical considerations, aetiology and review of the literature.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
A T al-KhodairyCharles Gobelet

Abstract

The principal author was confronted few years ago with the case of a 38-year-old woman with a 5-month history of ill-defined L5 sciatic pain that was referred to an orthopaedic department for investigation and eventual surgical treatment for what was suspected to be herniated disc-related sciatica. Removal of her enlarged uterus found unexpectedly close to the sacroiliac joint upon lumbar MRI abolished her symptoms. Review of the literature showed that the lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Physiological processes in the female patient and gynaecological diseases may be the source of sciatica, often not readily searched for, leading to fruitless investigations and surgical treatments. The aim of the paper is to highlight gynaecological and obstetrical causes of sciatica and sciatica-like symptoms. To prevent unproductive expenses and morbidity, a thorough gynaecological examination should be done even though neurological examination may be suggestive of a herniated intervertebral disc, and the cyclic pattern of pain related to menses should be routinely asked for.

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Citations

Jan 12, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Michel Benoist
Feb 14, 2009·Spine·Joan P Scannell, Stuart M McGill
Jan 5, 2012·Journal of Neurology·Laura GhezziElio Scarpini
Jan 23, 2014·British Journal of Neurosurgery·Maleeha AhmadSimon Thomson
Jan 10, 2014·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Xiaolin WangJiman He
Nov 22, 2012·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Susan E GeorgeDiane F Borello-France
Jul 13, 2016·The American Journal of Medicine·Steven F DeFrodaMatthew E Deren
May 31, 2017·Muscle & Nerve·Stéphane MathisJérôme Franques
Oct 26, 2016·World Journal of Clinical Oncology·Yoshihiro MatsumotoYukihide Iwamoto
Sep 8, 2019·Journal of Robotic Surgery·Bassel AbouzeidImad Mufarrij
Mar 14, 2021·Rehabilitación·J C Araque CancarM T Morales Palacios

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