Sciatic neuropathy complicating vaginal hysterectomy

Acute lumbar intervertebral disc prolapse: a complication of the lithotomy position

“…It is known that upper and lower parts of lumbosacral plexuses can be stretched between their respective origins and exits, beneath the inguinal ligament the greater sciatic foramen, respectively, by hyperabduction of the hip 9 . It is reported that simultaneous hip flexion and knee extension can stretch the sciatic nerve by approximately 1.5 inches 7 . In this case the spinal canal was already compromised due to congenital stenosis.…”

“…Vascular complications include the compartmental syndrome and thromboembolism 2 . Common neurological complications described are femoral 3–5 , sciatic 6,7 and peroneal 8 neuropathies. These peripheral neuropathies are usually stretch injuries resulting in various neurological deficits.…”

“…Considering the number of gynaecological, urological and colorectal procedures performed in the lithotomy position, the incidence of either neuropraxic or disco‐genic sciatic neuropathy is extremely low. Before computed tomography became available McQuarrie et al 7 reported sustained S1 nerve root compression due to a prolapsed disc following vaginal hysterectomy. In the last two decades, even with advanced neuro‐imaging and neuro‐physiological tests, post‐operative disc prolapse is a rare diagnosis, although post‐operative backache is common.…”

Claims Submitted To The Patient Insurance Scheme Regarding Complications To Treatment For Urinary Incontinence And Genital Prolapse During 1975–1979

“…There is a strong association between a lithotomy position and the occurrence of this neuropathy. The potential candidate for this complication is difficult to anticipate prior to the operation, but medico-legal implications require an awareness of this problem (13).…”

“…The patient in our study had rheumatoid arthritis in her general history. It is probably preferable for the patient to be in a comfortable position for operation before induction of anaesthesia (13). Fortunately, normal function is usually restored within 6 to 12 months (4).…”