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Extraspinal bone and soft-tissue tumors as a cause of sciatica. Clinical diagnosis and recommendations: analysis of 32 cases.
- Source :
-
Spine [Spine (Phila Pa 1976)] 1999 Aug 01; Vol. 24 (15), pp. 1611-6. - Publication Year :
- 1999
-
Abstract
- Study Design: Between 1982 and 1997, the authors treated 32 patients with sciatica who subsequently were found to have a tumor along the extraspinal course of the sciatic nerve.<br />Summary of Background Data: Extraspinal compression of the sciatic nerve by a tumor is a rare cause of sciatica. Signs and symptoms overlap those of the more common causes of sciatica (i.e., herniated disc and spinal stenosis).<br />Objective: To characterize the unique clinical presentation of these patients and to formulate guidelines that may lead to early diagnosis.<br />Methods: All pertinent clinical data and studies were reviewed retrospectively, and standard demographic data were collected for analysis.<br />Results: These patients typically sought treatment for an insidious onset of sciatic pain that was constant, progressive, and unresponsive to change in position or bed rest. The mean time to final diagnosis was 11.9 months (median, 6 months). Seventeen patients were able to locate their pain to a specific point along the extraspinal course of the sciatic pain, and a mass was noted in 13 patients. Eighteen of these tumors were in the pelvis, 10 in the thigh, and 4 in the popliteal fossa and calf.<br />Conclusions: A high index of clinical suspicion is the key to early diagnosis of bone or soft-tissue tumors as a cause of sciatica; special attention should be given to pain pattern, physical examination of the entire course of the sciatic nerve, and selection of proper imaging studies. Routine anteroposterior plain radiography of the pelvis as part of the initial imaging screening process is recommended.
- Subjects :
- Bone Neoplasms diagnosis
Bone Neoplasms epidemiology
Bone Neoplasms surgery
Female
Humans
Male
Middle Aged
Retrospective Studies
Soft Tissue Neoplasms diagnosis
Soft Tissue Neoplasms epidemiology
Soft Tissue Neoplasms surgery
Bone Neoplasms complications
Sciatica etiology
Soft Tissue Neoplasms complications
Subjects
Details
- Language :
- English
- ISSN :
- 0362-2436
- Volume :
- 24
- Issue :
- 15
- Database :
- MEDLINE
- Journal :
- Spine
- Publication Type :
- Academic Journal
- Accession number :
- 10457583
- Full Text :
- https://doi.org/10.1097/00007632-199908010-00017