Lower Extremity Radicular Pain Caused by Entrapped Sigmoid Colon Between L5 and S1 Vertebrae

Abstract

Intestinal entrapment between two vertebral bodies is very rare. In all previous cases, it occurred by major trauma. However, the bowel entrapment between two vertebral bodies without trauma has never been reported, not to mention as the cause of lower extremity radicular pain. We describe the case of an 82-year-old female patient with right lower extremity radicular pain without recent trauma history. The patient was diagnosed sigmoid colon entrapment between the L5 and S1 vertebrae by lumbar spinal computerized tomography and magnetic resonance imaging, and showed improvement in radicular pain after manual reduction of interpositioned colon during surgery. Intestinal entrapment between two vertebrae without trauma is caused by degenerative and vacuum changes of the intervertebral disc combined with the anterior longitudinal ligament injury.

Fracture and dislocation of lumbar vertebrae with entrapment of small bowel: A case report and literature review

“…Only 12 cases from seven countries with detailed clinical information were reported between 1979 and 2016 (Table 1). 2,4–14 The mean age of the patients was 24.2 years. Among the patients, six were children, of whom the youngest was 3 weeks old.…”

“…13 However, in one case, no trauma history was reported, so lumbar degenerative changes were considered to be the possible cause. 14…”

“…The incarcerated bowel was reset in all cases described in this report using these methods. 2,4–14 The authors of one study thought that posterior arthrodesis should be performed first to avoid iatrogenic nerve injuries while mobilizing the patient. 11 However, this approach may reduce the ability of lumbar hyperextension and make the resetting of the incarcerated bowel difficult.…”

“…During the postoperative course, some complications occurred in these 12 cases. 2,4–14 Pneumonia and left femoral vein thrombosis occurred in one patient; 7 Candida albicans infection and cortical infarcts in the distribution of the right middle cerebral artery occurred in one patient; 13 laparotomy wound infection occurred in one patient; 4 pulmonary embolism occurred in one patient; 8 retroperitoneal abscess on the tenth postoperative day occurred in one patient; 12 and one patient experienced a cerebrospinal fluid leak. 11 Five of 12 patients had different degrees of nerve injury.…”

Delayed Small Bowel Incarceration Within a Lumbar Burst Fracture After Posterior Spinal Fusion: A Case Report

“…Pesenti et al present a case involving an L3 chance fracture resulting in small bowel herniation within the spinal canal, resulting in cauda equina syndrome [8]. Another case from Ko et al describes the entrapment of the sigmoid colon within the L5-S1 interspace, causing S1 nerve root compression and radiculopathy requiring laparotomy, and the reduction of the colon combined with anterior lumbar interbody fusion [16].…”