EXTRASPINAL CAUSES OF SCIATICA - A CASE-REPORT

Study Design. A case of intrapelvic aneurysm is reported. It Ss as an example of one of the many extraspinal causes of sciatica. Objective. To demonstrate the importance of clinical examination in the assessmen t of patients with sciatica, despite continuing improvements in method s for imaging the spine. Summary of Background Data. Extraspinal condi tions cause sciatica in a rare hut recognized group of patients; Their clinical symptoms can be very similar to those of patients with sciat ica from lumbar disc protrusion. Methods. The clinical appearance, inv estigation, and treatment of a patient with an internal iliac artery a neurysm causing sciatica are discussed. Results; Surgical treatment of the patient's aneurysm resulted in relief of the symptoms or sciatica . Conclusions. Although these bases are unusual in isolation, together they represent an important group. When a patient has sciatica, the, clinician looks first to the spine for the origin of symptoms. Extrasp inal causes are often not considered in the differential diagnosis. Th is oversight maybe compounded by observation of asymptomatic disc prot rusions on computed tomographic and magnetic resonance studies. The im portance of clinical history and examination in the diagnosis of these lesions cannot be overemphasized.