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European Spine Journal
Published in: European Spine Journal 11/2016

01-11-2016 | Grand Rounds

Management of an unusual sciatica

Authors: Anouar Bourghli, Ahmed Chaballout, Ibrahim Obeid, Louis Boissiere, Jean-Marc Vital, Ghassan Khoury

Published in: European Spine Journal | Issue 11/2016

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Abstract

Purpose

Extraforaminal entrapment of the L5 nerve root is uncommon, and its management can sometimes be very challenging.

Methods

We present the case of a 57-year-old female, complaining of a sciatica in her left leg, for 3 years, with no response to any kind of conservative treatment. MRI and CT scan revealed the presence of a large L5S1 strictly lateral osteophyte compressing the left L5 root in its extraforaminal path.

Results

The patient underwent a left anterior retroperitoneal approach with assistance from a vascular surgeon given the very close relation between the osteophyte and the left common iliac vein, lying just on top of it, osteophyte was removed in one piece with the use of an osteotome after retraction of the vessels. The patient progressively recovered from her left sciatic pain with a satisfactory clinical result at 1 year.

Conclusion

Literature is sparse on the treatment of extraforaminal entrapment of the L5 nerve root; the current case shows a successful treatment strategy with the use of an anterior approach for direct vision of the lesion and good control of the vessels.
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Metadata
Title
Management of an unusual sciatica
Authors
Anouar Bourghli
Ahmed Chaballout
Ibrahim Obeid
Louis Boissiere
Jean-Marc Vital
Ghassan Khoury
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 11/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4446-z

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Grand Rounds

Expert’s comment concerning Grand Rounds case entitled “Management of an unusual sciatica” by A. Bourghli, A. Chaballout, I. Obeid, L. Boissiere, J.-M. Vital and G. Khoury (Eur Spine J; doi:10.1007/s00586-016-4446-z)

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