不寻常的坐骨神经被臀下动脉夹住
Unusual Sciatic Nerve Entrapment by the Inferior Gluteal Artery.
摘要(中文译文)
坐骨神经病通常归因于脊柱或肌肉原因，而血管相关性压迫仍被低估。我们报告一例由异常臀下动脉在臀部深区导致的坐骨神经卡压病例，患者表现为持续性右侧臀部和后大腿疼痛两年余，多种保守治疗均无效。体格检查显示明显的触诱发痛和界限明确的Tinel样征，症状放射至下肢，提示外周性病因。高分辨率超声检查发现一条异常的臀下动脉，该动脉跨越并压迫坐骨神经，形成坐骨神经的伴行动脉。多普勒成像证实该结构的血管性质，长轴视图显示局灶性神经压迫伴节段性肿胀。磁共振成像进一步证实了诊断。采用5%葡萄糖和利多卡因进行超声引导下液体分离术，症状显著缓解。治疗后疼痛评分从7分降至3分，两个月随访时症状消失。本病例突出了坐骨神经卡压的一种罕见神经血管病因，并强调了超声检查在识别解剖变异中的重要性。认识血管因素对臀部深综合征的贡献可能提高诊断准确性并指导针对性干预。
Abstract
Sciatic neuropathy is most commonly attributed to spinal or muscular causes, whereas vascular-related compression remains underrecognized. We report a case of sciatic nerve entrapment caused by an anomalous inferior gluteal artery in the deep gluteal region, who presented with persistent right gluteal and posterior thigh pain for more than two years, refractory to multiple conservative treatments. Physical examination demonstrated marked allodynia and a well-defined Tinel-like sign, with radiating symptoms extending to the lower limb, suggesting a peripheral etiology. High-resolution ultrasonography identified an aberrant inferior gluteal artery, which crossed over and compressed the sciatic nerve, forming an accompanying artery of the sciatic nerve. Doppler imaging confirmed the vascular nature of the structure, while long-axis views demonstrated focal nerve compression with segmental swelling. Magnetic resonance imaging further corroborated the diagnosis. Ultrasound-guided hydrodissection using 5% dextrose and lidocaine was performed, resulting in significant symptom relief. Pain scores improved from 7 to 3 after treatment, with resolution of symptoms at two-month follow-up. This case highlights a rare neurovascular cause of sciatic nerve entrapment and underscores the importance of ultrasonography in identifying anatomical variations. Recognition of vascular contributions to deep gluteal syndrome may improve diagnostic accuracy and guide targeted interventions.
如何引用
AMA
Wei-Ting Wu, Yu-Chun Hsu, Ke-Vin Chang, Levent Özçakar. Unusual Sciatic Nerve Entrapment by the Inferior Gluteal Artery.. Diagnostics (Basel, Switzerland). 2026; doi:10.3390/diagnostics16111668.
APA
Wei-Ting Wu, Yu-Chun Hsu, Ke-Vin Chang, Levent Özçakar (2026). Unusual Sciatic Nerve Entrapment by the Inferior Gluteal Artery.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics16111668
GB/T 7714
Wei-Ting Wu, Yu-Chun Hsu, Ke-Vin Chang, Levent Özçakar. Unusual Sciatic Nerve Entrapment by the Inferior Gluteal Artery.[J]. Diagnostics (Basel, Switzerland), 2026 doi:10.3390/diagnostics16111668.
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