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Journal of Korean Neurosurgical Society 1997;26(2): 173-177.
Acute Sciatica from Sacral Screw Impingement on the Lumbosacral Plexus: Emphasis on the Safe Zones for Sacral Screw Placement.
Jae Won Doh, Bark Jang Byun, Edward C Benzel
1Department of Neurosurgery, Soonchunhyang University Chonan Hospital, Chonan, Korea.
2Division of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, USA.
The authors present the case of sciatica due to bicortical sacral screw impingement on the lumbosacral plexus across the anterior sacrum. The placement of sacral screw across the anterior sacral cortex carries significant inherent risks to neurovascular and visceral structures. However, the clinical reports of lumbosacral plexus involvement by the misplaced screw are not well documented in the literature. This is an unique case of sciatica due to sacral screw impingement on the lumbosacral plexus after motor vehicle accident(MVA), and confirmed by CT scan and intraoperative electrical stimulation. We reviewed sacral anatomy and preventive measures for avoiding complication of this type are discussed.
Key Words: Sacrum; Screw penetration; Lumbosacral plexus; Sciatica; Safe zone
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