Öz
Aim: Our aim is to investigate the etiological factors and electrophysiological findings. of patients with sciatic nerve injury.
Materials and Methods: In the study, the files of the patients who referred to our electromyography (EMG) laboratory at January 2010-August 2013 were retrospectively investigated. Patients whose nerve conduction study and needle EMG were made with standard techniques were included to the study. Age, sex, etiology and history data of the cases from the files were obtained.
Results: A total of 3225 patients were screened retrospectively. The number of cases admitted with the preliminary diagnosis of sciatic nerve injury was 144 and ultimately sciatic nerve lesion was diagnosed in 50 patients. The ages of patients were between 7-88; 79.6% of patients were male and 20.4% female. Among the etiological factors, femoral fractures ranked first (38%) and intramuscular injections were second (20%). In all cases peroneal nerve injury was detected, however there was no damage of tibial nerve in 14% of the cases. All the patients with tibial nerve lesion was accompanied by the peroneal nerve injury. Also 38% of peroneal nerve injury and 18% of tibial nerve lesions were total. Fracture etiology identified as the most frequent cause with 50% ratio.
Conclusion: Etiologic evaluation and electrophysiological studies has an importanat role for the management of sciatic neuropathy in terms of early diagnosis, optimal treatment and timing.
Anahtar Kelimeler
Kaynakça
- Moore KL, Dalley AF. Lower limb. Clinically Oriented Anatomy. 4th ed. Baltimore: Lippincott Williams & Wilkins; 1999:558-9.
- Burks SS, Levi DJ, Hayes S, Levi AD. Challenges in sciatic nerve repair: Anatomical considerations. J Neurosurg 2014;121(1):210-8.
- Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop 1987;218(1):136-41.
- Kim DH, Murovic JA, Tiel R, Kline DG. Management and outcomes in 353 surgically treated sciatic nerve lesions. J Neurosurg 2004;101(1):8-17.
- Kline DG, Kim D, Midha R, Harsh C, Tiel R. Management and results of sciatic nerve injuries: A 24-year experience. J Neurosurg 1998;89(1):13-23.
- Igor I, Andrew EP, Israel A, John A IG. Lower Extremity Nerve Trauma. Bull Hosp Jt Dis 2014;72(1):43-52.
- Aldea PA, Shaw WW. Lower extremity nerve injuries. Clin Plast Surg 1986;13(4):691-9.
- Taylor CA, Braza D, Rice JB, Dillingham T. The incidence of peripheral nerve injury in extremity trauma. Am J Phys Med Rehabil 2008;87(5):381-5.
- Uzun N, Tanriverdi T, Savrun FK, et al. Traumatic peripheral nerve injuries: Demographic and electrophysiologic findings of 802 patients from a developing country. J Clin Neuromuscul Dis 2006;7(3):97-103.
- Kouyoumdjian JA. Peripheral nevre injuries: A retrospective survey of 456 cases. Muscle Nerve 2006;34(6):785-8.
- Noble J, Munro CA, Prasad VS, Midha R. Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries. J Trauma 1998;45(1):116-22.
- Schmalzried TP, Noordin S, Amstutz H. Update on nerve palsy associated with total hip replacement. Clin Orthop 1997;344(1):188-206.
- Pazarcı NK, Orken DN, Çelik MG, Çelebi LG, Aydın Ş. Postenjeksiyon siyatik nöropati: Klinik ve elektrofizyolojik özellikler. Nöropsikiyatri Arşivi 2010;47(1):207-12.
- Fassler PR, Swiontkowski MF, Kilroy AW, Routt MLJ. Injury of the sciatic nerve associated with acetabuler fracture. J Bone Joint Surg 1993;75(8):1157-66.
- Yuen EC, Olney RK, So YT. Sciatic neuropathy: Clinical and prognostic features in 73 patients. Neurology 1994;44(1):1669-74.
- Eser F, Aktekin LA, Bodur H, Atan C. Etiological factors of traumatic peripheral nerve injuries. Neurol India 2009;57(4):434-7.
- Stewart JD. Focal peripheral neuropathies. Amsterdam: Elsevier; 1987:270-306.
- Mishra P, Stringer MD. Sciatic nerve injury from intramuscular injection: A persistent and global problem. Int J Clin Pract 2010;64(1):1573-9. 19. Kim HJ, Park SH. Sciatic nerve injection injury. J Int Med Res 2014;42(4):887-97.
- Hudson A, Kline D, Gentilli F. Peripheral nerve injection injury. In: Omer GE Jr, Spinner M (ed). 2nd ed. Management of Peripheral Nerve Problems. Philadelphia: WB Saunders; 1980:546-60.
- Yuen EC, So YT. Sciatic neuropathy. Neurol Clin 1999;17(3):617-31.
- Bodur H, Uçan H. Periferik sinir yaralanmalı olgularımız. Romatizma 1998;2(1):105-8.
Siyatik sinir yaralanmalarında etiyolojik faktörler ile elektrofizyolojik bulguların değerlendirilmesi
Öz
Amaç: Elektromiyografi (EMG) laboratuvarına başvuran siyatik sinir yaralanmalı hastalarda elektrofizyolojik bulgular eşliğinde etiyolojik faktörlerin incelenmesi hedeflendi.
Gereç ve Yöntem: Bu çalışmada, Ocak 2010 ile Ağustos 2013 tarihleri arasında elektromiyografi (EMG) laboratuvarında incelenen olgular retrospektif olarak incelendi. Standart yöntemlerle sinir ileti ölçümleri ve iğne elektromiyografisi yapılmış olan hastalar çalışmaya alındı. Hasta dosyalarından olgulara ait yaş, cinsiyet, etiyoloji ve öykü ile ilgili veriler elde edildi.
Bulgular: Geriye dönük olarak toplam 3225 olgu tarandı. Siyatik sinir hasarı şüphesiyle EMG laboratuvarına gönderilen olgu sayısı 144’tü; 50 olguda siyatik sinir hasarı saptandı. Çalışmaya alınan hastaların yaşları 7-88 arasındaydı. Hastaların %80’i erkek, %20’si kadındı. Etiyolojik nedenler arasında %38 ile femur fraktürü ilk sırada yer alırken %20 ile im enjeksiyonlar ikinci sıradaydı. Vakaların tümünde peroneal sinir hasarı saptandı,%14’ünde tibial sinirde hasarlanma yoktu. Tibial sinir hasarı olan olguların hepsinde peroneal sinir hasarı bulunuyordu. Peroneal sinir yaralanmalarının %38’i, tibial sinir yaralanmalarının ise %18’i total tutulumluydu. En sık neden olarak saptanan kırık etiyolojisinin oranı %50 idi.
Sonuç: Siyatik nöropatilerin yönetiminde, etiyolojik değerlendirme ve elektrofizyolojik inceleme erken tanı, optimal tedavi ve zamanlama açısından önemli yer tutmaktadır.
Anahtar Kelimeler
Kaynakça
- Moore KL, Dalley AF. Lower limb. Clinically Oriented Anatomy. 4th ed. Baltimore: Lippincott Williams & Wilkins; 1999:558-9.
- Burks SS, Levi DJ, Hayes S, Levi AD. Challenges in sciatic nerve repair: Anatomical considerations. J Neurosurg 2014;121(1):210-8.
- Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop 1987;218(1):136-41.
- Kim DH, Murovic JA, Tiel R, Kline DG. Management and outcomes in 353 surgically treated sciatic nerve lesions. J Neurosurg 2004;101(1):8-17.
- Kline DG, Kim D, Midha R, Harsh C, Tiel R. Management and results of sciatic nerve injuries: A 24-year experience. J Neurosurg 1998;89(1):13-23.
- Igor I, Andrew EP, Israel A, John A IG. Lower Extremity Nerve Trauma. Bull Hosp Jt Dis 2014;72(1):43-52.
- Aldea PA, Shaw WW. Lower extremity nerve injuries. Clin Plast Surg 1986;13(4):691-9.
- Taylor CA, Braza D, Rice JB, Dillingham T. The incidence of peripheral nerve injury in extremity trauma. Am J Phys Med Rehabil 2008;87(5):381-5.
- Uzun N, Tanriverdi T, Savrun FK, et al. Traumatic peripheral nerve injuries: Demographic and electrophysiologic findings of 802 patients from a developing country. J Clin Neuromuscul Dis 2006;7(3):97-103.
- Kouyoumdjian JA. Peripheral nevre injuries: A retrospective survey of 456 cases. Muscle Nerve 2006;34(6):785-8.
- Noble J, Munro CA, Prasad VS, Midha R. Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries. J Trauma 1998;45(1):116-22.
- Schmalzried TP, Noordin S, Amstutz H. Update on nerve palsy associated with total hip replacement. Clin Orthop 1997;344(1):188-206.
- Pazarcı NK, Orken DN, Çelik MG, Çelebi LG, Aydın Ş. Postenjeksiyon siyatik nöropati: Klinik ve elektrofizyolojik özellikler. Nöropsikiyatri Arşivi 2010;47(1):207-12.
- Fassler PR, Swiontkowski MF, Kilroy AW, Routt MLJ. Injury of the sciatic nerve associated with acetabuler fracture. J Bone Joint Surg 1993;75(8):1157-66.
- Yuen EC, Olney RK, So YT. Sciatic neuropathy: Clinical and prognostic features in 73 patients. Neurology 1994;44(1):1669-74.
- Eser F, Aktekin LA, Bodur H, Atan C. Etiological factors of traumatic peripheral nerve injuries. Neurol India 2009;57(4):434-7.
- Stewart JD. Focal peripheral neuropathies. Amsterdam: Elsevier; 1987:270-306.
- Mishra P, Stringer MD. Sciatic nerve injury from intramuscular injection: A persistent and global problem. Int J Clin Pract 2010;64(1):1573-9. 19. Kim HJ, Park SH. Sciatic nerve injection injury. J Int Med Res 2014;42(4):887-97.
- Hudson A, Kline D, Gentilli F. Peripheral nerve injection injury. In: Omer GE Jr, Spinner M (ed). 2nd ed. Management of Peripheral Nerve Problems. Philadelphia: WB Saunders; 1980:546-60.
- Yuen EC, So YT. Sciatic neuropathy. Neurol Clin 1999;17(3):617-31.
- Bodur H, Uçan H. Periferik sinir yaralanmalı olgularımız. Romatizma 1998;2(1):105-8.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Eylül 2017 |
| Gönderilme Tarihi | 11 Ağustos 2016 |
| Yayımlandığı Sayı | Yıl 2017 |