case_images: PMC3163138_01
case_images: Radiological anteroposterior radiographs of the pelvis showing the Burch Schneider metal cage.
case_images: CRIM2011-830296.001.jpg
case_images: PMC3163138_01_CRIM2011-830296.001.jpg
case_images: fig1
case_images: After six days of pharmacological treatment, the sciatalgic pain was evaluated with a magnetic resonance (MR) which demonstrated L1-L2 and L3-L4 herniated discs, but no specific radicular compression.The radiological evaluation of the prosthesis did not show mobilization or malpositioning of the implant (Figure 1).
case_images: The sciatic nerve (A) compressed by fibrotic tissue (B) after the section of the external rotator muscles (C).
case_images: CRIM2011-830296.002.jpg
case_images: PMC3163138_01_CRIM2011-830296.002.jpg
case_images: fig2
case_images: After the section of the tendon of the external rotator muscles group and of the piriformis muscle, the nerve appeared clearly embedded in a fibrotic tissue (Figure 2).
case_images: The sciatic nerve (A) impinging on the metal cage (B).
case_images: CRIM2011-830296.003.jpg
case_images: PMC3163138_01_CRIM2011-830296.003.jpg
case_images: fig3
case_images: Moreover, a straight relationship between the sciatic nerve and the Schneider ring was found (Figure 3): this relationship caused the compression of the nerve itself on the metallic cage, particularly during the movement of flexion of the hip, which clearly stretched the nerve.
case_images: The muscular flap (A) positioned between the sciatic nerve (B) and the metallic cage: (a) preparation of the flap, (b) the flap in its final position.
case_images: CRIM2011-830296.004.jpg
case_images: PMC3163138_01_CRIM2011-830296.004.jpg
case_images: fig4
case_images: The nerve was carefully released from the fibrotic tissue, and a muscular flap was made using part of the dissected profundus gluteus muscle to allow a nerve glide on the ischiatic bone and on the edge of the Burch Schneider metal cage (Figure 4).