这篇综述旨在比较孤立的坐骨神经和骶神经根子宫内膜异位症的解剖分布。患者的症状和病史,诊断,治疗,和结果。
我们搜索了PubMed,MEDLINE,WebofScience,和Embase从成立到2021年10月,使用包括“坐骨神经子宫内膜异位症”在内的关键字组合,骶神经根子宫内膜异位症,\“及相关医学主题词。还检查了有关出版物和参考文献的其他文章。
两名独立的研究人员进行了研究选择。我们包括了所有原创研究文章,病例报告,和英文病例系列报道了孤立的坐骨神经和骶神经根子宫内膜异位症。
最初的搜索确定了92篇文章,40篇文章,主要是病例报告和病例系列,包括在内。该综述包括362例患者:骶骨和坐骨神经组256例和106例患者,分别。在这两组中,大多数患者患有右侧子宫内膜异位症.在坐骨神经组中,大多数患者出现足下垂,腿部运动无力,和坐骨神经的皮肤感觉减退。所有这些症状的频率在坐骨神经组中显著较高(所有p<.001)。相比之下,在骶骨组中,大多数患者表现为阴部神经痛(p<.001)。术中,早期,迟到,术后1年并发症两组间无显著差异.
这项研究表明,孤立的坐骨和骶神经根子宫内膜异位症在右侧更常见。腹腔镜手术比传统的开放或经臀围手术技术更常见。骶神经根子宫内膜异位症常伴有深部浸润型子宫内膜异位症。磁共振成像和脊髓造影可能是术前检查中有用的诊断工具。在孤立的坐骨神经子宫内膜异位症表现为足下垂的情况下,手术后通常没有显着改善。
This review aimed to compare isolated sciatic and sacral nerve root endometriosis in terms of anatomic distribution, patients\' symptoms and history, diagnostics, treatments, and outcomes.
We searched PubMed, MEDLINE, Web of Science, and Embase from inception to October 2021 using a combination of keywords including \"sciatic nerve endometriosis,\" \"sacral nerve root endometriosis,\" and associated Medical Subject Headings. Relevant publications and references were also checked for further articles.
Two independent researchers performed the study selection. We included all original research articles, case reports, and case series in English that reported on the isolated sciatic nerve and sacral nerve root endometriosis.
The initial search identified 92 articles, and 40 articles, mostly case reports and case series, were included. The review included 362 patients: with 256 and 106 patients in the sacral and the sciatic groups, respectively. In both groups, most patients had right-sided endometriosis. In the sciatic group, most of the patients presented with foot drop, leg motor weakness, and sciatic dermatome hypoesthesia. The frequencies of all these symptoms were significantly higher in the sciatic group (all p <.001). By contrast, in the sacral group, most of patients presented with pudendal neuralgia (p <.001). Intraoperative, early, late, and 1-year postoperative complications did not differ significantly between the 2 groups.
This study indicated that isolated sciatic and sacral nerve root endometrioses were more common on the right side. Laparoscopic surgery was more commonly performed over traditional open or transgluteal surgery techniques. Sacral nerve root endometriosis is often accompanied by deep infiltrating endometriosis. Magnetic resonance imaging and myelography may be useful diagnostic tools in the preoperative workup. There was usually no significant improvement after surgery in cases of isolated sciatic nerve endometriosis presenting with foot drop.