Skip to main content
Top
Published in: Journal of Orthopaedic Science 4/2013

01-07-2013 | Case Report

Surgical removal of a partial ossified sacrotuberous ligament for refractory pudendal nerve entrapment syndrome

Authors: Andrea Sandri, Dario Regis, Mirko Toso, Pietro Bartolozzi

Published in: Journal of Orthopaedic Science | Issue 4/2013

Login to get access

Excerpt

The sacrotuberous ligament (STL) extends from the sacrum, posterior iliac spine, and coccyx to the medial surface of ischial tuberosity, stabilizing the pelvis and locking the sacroiliac joint [1, 2]. Recent studies have reported the association between the STL and pudendal nerve entrapment (PNE) syndrome, described as a severe pain along the course of the pudendal nerve, the principal nerve supplying the perineum [3, 4]. Little attention has been paid to the role of the ossified STL in compression of the pudendal nerve. In a cadaveric study, Arora et al. [5] reported the topography and morphometry of a unilateral partial ossification of STL, which was identified as a potential factor for PNE syndrome. …
Literature
1.
go back to reference Standring S, Ellis H, Healy J, Johnson D, Williams A. Gray’s anatomy. 39th ed. London: Elsevier Churchill Livingstone; 2005. p. 1428–39. Standring S, Ellis H, Healy J, Johnson D, Williams A. Gray’s anatomy. 39th ed. London: Elsevier Churchill Livingstone; 2005. p. 1428–39.
2.
go back to reference Simmons DN. Sonography of the sacrotuberous ligament. ASUM Ultrasound Bull. 2008;11(2):25–30. Simmons DN. Sonography of the sacrotuberous ligament. ASUM Ultrasound Bull. 2008;11(2):25–30.
3.
go back to reference Loukas M, Louis RG Jr, Hallner B, Gupta AA, White D. Anatomical and surgical considerations of the sacrotuberous ligament and its relevance in pudendal nerve entrapment syndrome. Surg Radiol Anat. 2006;28(2):163–9.PubMedCrossRef Loukas M, Louis RG Jr, Hallner B, Gupta AA, White D. Anatomical and surgical considerations of the sacrotuberous ligament and its relevance in pudendal nerve entrapment syndrome. Surg Radiol Anat. 2006;28(2):163–9.PubMedCrossRef
4.
go back to reference Robert R, Labat JJ, Riant T, Louppe JM, Hamel O. The pudendal nerve: clinical and therapeutic morphogenesis, anatomy, and physiopathology. Neurochirurgie. 2009;55(4–5):463–9.PubMedCrossRef Robert R, Labat JJ, Riant T, Louppe JM, Hamel O. The pudendal nerve: clinical and therapeutic morphogenesis, anatomy, and physiopathology. Neurochirurgie. 2009;55(4–5):463–9.PubMedCrossRef
5.
go back to reference Arora J, Mehta V, Suri RK, Rath G. Unilateral partial ossification of sacrotuberous ligament: anatomico-radiological evaluation and clinical implications. Rom J Morphol Embryol. 2009;50(3):505–8.PubMed Arora J, Mehta V, Suri RK, Rath G. Unilateral partial ossification of sacrotuberous ligament: anatomico-radiological evaluation and clinical implications. Rom J Morphol Embryol. 2009;50(3):505–8.PubMed
6.
go back to reference Prescher A, Bohndorf K. Anatomical and radiological observations concerning ossification of the sacrotuberous ligament: is there a relation to spinal diffuse idiopathic skeletal hyperostosis (DISH)? Skeletal Radiol. 1993;22(8):581–5.PubMedCrossRef Prescher A, Bohndorf K. Anatomical and radiological observations concerning ossification of the sacrotuberous ligament: is there a relation to spinal diffuse idiopathic skeletal hyperostosis (DISH)? Skeletal Radiol. 1993;22(8):581–5.PubMedCrossRef
7.
go back to reference Beyth S, Liebergall M, Mosheiff R. Myositis ossificans circumscripta of the sacrotuberous ligament: a case report and review of the literature. J Orthop Trauma. 2002;16(9):672–4.PubMedCrossRef Beyth S, Liebergall M, Mosheiff R. Myositis ossificans circumscripta of the sacrotuberous ligament: a case report and review of the literature. J Orthop Trauma. 2002;16(9):672–4.PubMedCrossRef
8.
go back to reference Shafik A, El Sibai O, Shafik IA, Shafik AA. Role of sacral ligament clamp in the pudendal neuropathy (pudendal canal syndrome): results of clamp release. Int Surg. 2007;92(1):54–9.PubMed Shafik A, El Sibai O, Shafik IA, Shafik AA. Role of sacral ligament clamp in the pudendal neuropathy (pudendal canal syndrome): results of clamp release. Int Surg. 2007;92(1):54–9.PubMed
9.
go back to reference Filler AG. Diagnosis and treatment of pudendal nerve entrapment syndrome subtypes: imaging, injections, and minimal access surgery. Neurosurg Focus. 2009;26(2):E9.PubMedCrossRef Filler AG. Diagnosis and treatment of pudendal nerve entrapment syndrome subtypes: imaging, injections, and minimal access surgery. Neurosurg Focus. 2009;26(2):E9.PubMedCrossRef
10.
go back to reference Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Rigaud J. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn. 2008;27(4):306–10.PubMedCrossRef Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Rigaud J. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn. 2008;27(4):306–10.PubMedCrossRef
11.
go back to reference Filippiadis DK, Velonakis G, Mazioti A, Alexopoulou E, Malagari A, Brountzos E, Kelekis N, Kelekis A. CT-guided percutaneous infiltration for the treatment of Alcock’s neuralgia. Pain Physician. 2011;14(2):211–5.PubMed Filippiadis DK, Velonakis G, Mazioti A, Alexopoulou E, Malagari A, Brountzos E, Kelekis N, Kelekis A. CT-guided percutaneous infiltration for the treatment of Alcock’s neuralgia. Pain Physician. 2011;14(2):211–5.PubMed
12.
go back to reference Hough DM, Wittenberg KH, Pawlina W, Maus TP, King BF, Vrtiska TJ, Farrell MA, Antolak SJ Jr. Chronic perineal pain caused by pudendal nerve entrapment: anatomy and CT-guided perineural injection technique. AJR Am J Roentgenol. 2003;181(2):561–7.PubMedCrossRef Hough DM, Wittenberg KH, Pawlina W, Maus TP, King BF, Vrtiska TJ, Farrell MA, Antolak SJ Jr. Chronic perineal pain caused by pudendal nerve entrapment: anatomy and CT-guided perineural injection technique. AJR Am J Roentgenol. 2003;181(2):561–7.PubMedCrossRef
Metadata
Title
Surgical removal of a partial ossified sacrotuberous ligament for refractory pudendal nerve entrapment syndrome
Authors
Andrea Sandri
Dario Regis
Mirko Toso
Pietro Bartolozzi
Publication date
01-07-2013
Publisher
Springer Japan
Published in
Journal of Orthopaedic Science / Issue 4/2013
Print ISSN: 0949-2658
Electronic ISSN: 1436-2023
DOI
https://doi.org/10.1007/s00776-012-0202-3

Other articles of this Issue 4/2013

Journal of Orthopaedic Science 4/2013 Go to the issue