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Neurological Surgery No Shinkei Geka Volume 38, Issue 11 （November 2010）

Neurological Surgery 脳神経外科 38巻11号（2010年11月発行）

Japanese English

症例

腰椎術後の鼠径部痛の原因であった仙腸関節障害の1例 Sacroiliac Joint Dysfunction with Groin Pain after an Operation for Lumbar Spinal Disorder. A Case Report 下田祐介 ¹ , 森本大二郎 ¹ , 井須豊彦 ¹ , 茂木洋晃 ¹ , 今井哲秋 ¹ , 松本亮司 ¹ , 磯部正則 ¹ , 金景成 ² , 菅原淳 ³ Yusuke SHIMODA ¹ , Daijiro MORIMOTO ¹ , Toyohiko ISU ¹ , Hiroaki MOTEGI ¹ , Tetsuaki IMAI ¹ , Ryouji MATSUMOTO ¹ , Masanori ISOBE ¹ , Kyongsong KIM ² , Atsushi SUGAWARA ³ ¹釧路労災病院脳神経外科 ²日本医科大学脳神経外科 ³岩手医科大学脳神経外科 ¹Department of Neurosurgery,Kushiro Rosai Hospital ²Department of Neurosurgery,Nippon Medical School ³Department of Neurosurgery,Iwate Medical School キーワード： sacroiliac joint dysfunction , groin pain , spondylolisthesis , postoperative complication Keyword: sacroiliac joint dysfunction , groin pain , spondylolisthesis , postoperative complication pp.1025-1030

発行日 2010年11月10日 Published Date 2010/11/10

DOI https://doi.org/10.11477/mf.1436101285

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参考文献 Reference

Ⅰ．はじめに

　仙腸関節障害は，腰痛と表現される仙腸関節部の疼痛に加えて，関連症状として下肢の疼痛や痺れを呈する．今回われわれは，腰椎変性疾患の術後に出現した鼠径部痛の原因であった仙腸関節障害の1例を経験したので，若干の文献的考察を含めて報告する．

　A 75-year-old male presented with groin pain after an operation to treat lumbar spondylolisthesis (L5). Groin tenderness was localized to the medial border of the anterior superior iliac spine (ASIS). Radiographical and physical examination raised the suspicion of sacroiliac joint (SIJ) dysfunction. Injection of a painkiller into the SIJ relieved symptoms, including groin tenderness. Symptoms improved gradually, and finally disappeared after five SIJ injections. Groin pain has been reported as a referred symptom of SIJ dysfunction in 9.3～23% of patients. Prior to the patient undergoing surgery to treat lumbar spondylolisthesis, SIJ dysfunction had not been noted on physical examination. Long periods spent in the abnormal posture due to lumbar spondylolisthesis induced SIJ stress. After the operation, an improvement in daily activity actually increased stress on the SIJ, resulting in SIJ dysfunction. Certain pathologies, including SIJ dysfunction, should be considered as residual symptoms after operations for lumbar spinal diseases.