Lumbosacral plexus lesions.
BACKGROUND
Aim of the present study was to analyse the main causes of lumbosacral plexus lesions together with the best diagnostic and therapeutic options for better patient outcome.


METHODS
We report our surgical experience with eight patients in whom lesion mechanisms consisted of high-energy trauma (4 pts), firearm injuries (2 pts), spontaneous retroperitoneal haematoma in anticoagulant therapy (1 pt) and schwannoma (1 pt). The diagnosis was not straightforward and included clinical aspects, electrophysiological studies, magnetic resonance and CT myelography. Surgery was performed by lateral extraperitoneal approach for the lumbar plexus, transperitoneal approach on the midline to reach the sacral plexus, and neuronavigation was used in the schwannoma case.


CONCLUSIONS
Lumbosacral plexus lesions require a challenging multidisciplinary approach to diagnose and treat; the outcome, even if delayed, was very encouraging. In all our patients pain was controlled, and six patients returned to unaided walking.
Stevanato
G
G
Department of Neurosurgery, Umberto I Hospital, Mestre-Venezia, Italy. giorgio.stevanato@ulss12.ve.it
Vazzana
L
L
Daramaras
S
S
Trincia
G
G
Saggioro
G C
GC
Squintani
G
G
D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects; D004568:Electrodiagnosis; D006406:Hematoma / Q000139:chemically induced / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008160:Lumbosacral Plexus / Q000293:injuries* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009121:Muscle Denervation; D009192:Myelography; D009442:Neurilemmoma / Q000150:complications* / Q000601:surgery; D038361:Neuronavigation; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012186:Retroperitoneal Neoplasms / Q000150:complications* / Q000601:surgery; D012187:Retroperitoneal Space / Q000098:blood supply*; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000601:surgery
D000925:Anticoagulants