[Traumatic elongation-traction lesions of the roots of the sciatic nerve, secondary to fractures of the pelvis].
Three cases of complex pelvic fractures associated with lumbo sacral roots lesions are reported. The authors stress this possible association should be suspected through clinical and conventional radiological findings. The contrast sacco-radiculography brings up confirmation. However the so called pseudo-meningocele is by far of less topographical value than the same myelographic findings at cervical level (for brachial plexus avulsion injuries). Direct and concise evaluation is performed by surgical approach of roots during a homolateral hemi-laminectomy. This procedure allows to appreciate the anatomical lesions and to clarify the anatomo-radiological discrepancies. Moreover endodural closure and reduction of volume of meningoceles and removal of arachnoidal adhesions is to pain relief value and may prevent delayed complications of neighboring roots compression related to increase in volume of meningocele. According to the literature and our findings, in future, the aim should be microsurgical repair of such roots lesions as they ar not avulsed from the conus but merely more distally ruptured on the cauda equina. We could not so far achieve this procedure, because of difficulties to identify the distal part of root, often retracted far away from its spinae foramen.
D000293:Adolescent; D000328:Adult; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D012584:Sciatic Nerve / Q000293:injuries* / Q000601:surgery; D013126:Spinal Nerve Roots / Q000293:injuries* / Q000601:surgery
Lésions d'élongation-traction traumatique des racines du nerf sciatique, secondaires aux fractures de la ceinture pelvienne.