Vascular compression syndrome of sciatic nerve caused by gluteal varicosities.
Sciatica is defined as pain or discomfort along the regions innervated by the sciatic nerve. Compression or irritation of lumbar spinal roots, most commonly because of lumbar disc herniation or spinal stenosis, causes sciatica in the vast majority of cases. Although it is rather uncommon, many pathologies have reported to cause nondiscogenic sciatica. A 70-year-old woman presented with intractable sciatic pain which was not elicited by posture change or cough. Sitting on the affected side provoked more pain than standing or walking. Magnetic resonance imaging revealed both spondylolisthesis with lumbar stenosis and compression of the gluteal portion of the sciatic nerve by varicotic gluteal veins. Given the atypical presentation of spinal root compression, gluteal vascular compressive neuropathy was suspected. Ligation and resection of varicotic vein resulted in relief of the patient's pain. To our knowledge, cases with varicosity-caused sciatica were limited in the literature review.
Hu
Ming-Hsiao
MH
Department of Orthopaedic Surgery, National Taiwan University Hospital, Yun-lin Branch, Douliou City, Yunlin County, Taiwan, Republic of China.
Wu
Kuan-Wen
KW
Jian
Yu-Ming
YM
Wang
Chen-Ti
CT
Wu
I-Hui
IH
Yang
Shu-Hua
SH
D000368:Aged; D002081:Buttocks / Q000098:blood supply*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008026:Ligation; D008279:Magnetic Resonance Imaging; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010147:Pain Measurement; D010148:Intractable Pain / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012585:Sciatica / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome; D014648:Varicose Veins / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014656:Vascular Surgical Procedures