title: L5 radiculopathy secondary to intrapelvic placement of acetabular cup fixation screw.
abstract: We report a case of L5 radiculopathy secondary to intrapelvic placement of an acetabular screw impinging on the lumbosacral trunk. A 43-year-old man underwent revision of an uncemented total hip replacement to a custom-made femoral component and uncemented cup. He subsequently developed hip pain, dysesthesia, and L5 radiculopathy. Spiral computed tomography (CT) and plain radiographs raised the possibility of an acetabular screw abutting the neurovascular bundle within the pelvis. Operative removal of the intrapelvic portion of the screw resulted in the immediate relief of the patient's radicular symptoms. This case report highlights the importance of the positioning of intrapelvic screws and the need for an anatomic awareness of the structures at risk during acetabular screw placement.
authors.affiliation: From the Department of Trauma and Orthopaedics, Whittington Hospital NHS Trust, London, UK.
authors.forename: L H
authors.initials: LH
authors.lastname: Yuen
authors.forename: M A
authors.initials: MA
authors.lastname: Ishaque
authors.forename: A A
authors.initials: AA
authors.lastname: Narvani
authors.forename: L F
authors.initials: LF
authors.lastname: Wilson
authors.forename: E
authors.initials: E
authors.lastname: Tsiridis
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation; D001863:Bone Screws / Q000009:adverse effects*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D010384:Pelvic Bones / Q000601:surgery; D011843:Radiculopathy / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography