Although sciatica is commonly associated with lumbar spinal issues, it is important to acknowledge that non-spinal factors can also play a significant role in this condition. This is particularly relevant for female patients, in whom gynecologic conditions can lead to secondary sciatic neuropathy. Herein, we report the case of a 66-year-old woman who experienced posterolateral right lower extremity radiating pain. We initially performed a lumbar transforaminal epidural steroid injection, but the pain persisted. Subsequently, hip MRI revealed sciatic neuropathy adjacent to the pedunculated portions of a uterine myoma. We then performed a sub-gluteal sciatic nerve block under ultrasound guidance, resulting in significant relief of her pain. In conclusion, hip MRI can be helpful for the differential diagnosis of sciatica, and ultrasound-guided sciatic nerve block can be considered an appropriate and effective treatment option.

Citations

Citations to this article as recorded by  

• AVANÇOS E PERSPECTIVAS NA ANESTESIA NEUROAXIAL: SEGURANÇA, EFICÁCIA E APLICAÇÕES CLÍNICAS MODERNAS
  Gabriel Fontes , Julia de Souza e Silva, Gabriel Vitor Ferreira, Sofia Boechat Melado, Guilherme Soares Carvalho, Julia Kalene Saraiva Torres, Leonardo Lanes Leite Silvestre, Luís Pedro Cerqueira Morejón, Laryssa Inácio Carvalho, Matheus dos Santos Nunes,
  Revista Contemporânea.2025; 5(1): e7282.     CrossRef
• Gabapentin/Limaprost
  
  Reactions Weekly.2024; 2032(1): 187.     CrossRef

An 84-year-old woman visited our pain clinic with complaints of low back pain and severe radiating pain in the right lower extremity during walking. The patient demonstrated subacute compression fracture of L3 with vacuum change in lumbar spine plain radiographs and MRI which suggest Kummell’s disease. Despite our conservative treatments, she had little back pain relief. Therefore, we planned a percutaneous vertebroplasty. Manual compression could help perform percutaneous vertebroplasty more effectively by expanding the vertebral body. In addition, the spontaneous recovery of vacuum cleft width using negative pressure could help perform the technique more effectively. We successfully performed percutaneous vertebroplasty using these combination therapies for our patient.