Post-traumatic sciatic nerve neuropathy
The sciatic nerve (n. Ischiadicus) is a nerve that is mixed in functions (it is also responsible for movement and sensitivity). The most powerful nerve of the human body, consisting of fibers L5, S1, S2, S3 - spinal nerves.
Diagnostics of the traumatic neuritis of the sciatic nerve
Only very high (in level) the affected sciatic nerve - above the gluteal fold, in addition to the loss of the functions of the tibial and peroneal nerves, can lead to loss of function of the muscles that the sciatic nerve innervates on the thigh, resulting in the impossibility of flexion of the lower leg.
Such high lesions of the sciatic nerve are often accompanied by a simultaneous lesion of the posterior cutaneous nerve of the thigh. Naturally, with a complete defeat of the sciatic nerve, the functions of both its branches - the tibial and peroneal nerves - suffer, which gives the main symptom complex in the form of complete paralysis of the foot and fingers, loss of the Achilles tendon reflex and anesthesia of almost the entire leg and foot.
Sciatic nerve lesions can be accompanied by severe pain. The sciatic nerve, when irritated and inflamed, gives the characteristic symptom of Lasegue tension.
If a patient with sciatica in the supine position bends in the hip joint (lift) the leg straightened at the knee joint, then pain occurs along its back surface (pulls the leg), which is given by the sciatic nerve. This checks the tension that the sciatic nerve experiences, located along the back of the thigh and lower leg (the first phase of the Lasegue reception).
If with sciatica, bend the leg at the knee joint, thereby weakening the sciatic nerve from tension, then further flexion in the hip joint occurs painlessly (the second phase of Lasegue's reception).
Anatomically, the sciatic nerve is divided into the tibial and peroneal nerves. The sciatic nerve makes this division, as a rule, in the upper part of the popliteal fossa. However, a completely distinct subepineural isolation of the peroneal and tibial portions of the sciatic nerve is usually carried out in the pelvic cavity.
Injuries to such a large nerve as the sciatic nerve are rarely complete. More often, one or another portion of the sciatic nerve (a peroneal or tibial portion of the sciatic nerve) suffers more.
Damage to the sciatic nerve is possible with a dislocation of the hip when the displaced articular head of the femur causes compression and stretching of the sciatic nerve trunk.
Treatment of traumatic neuritis of the sciatic nerve
Treatment of traumatic neuritis of the sciatic nerve takes into account the level of damage to the nerve itself, the degree of accompanying movement, and sensory disorders in the leg. Different stages of the course of sciatic nerve neuropathy may require a different approach in choosing a therapeutic effect. It should be remembered that long-term neuropathy of the sciatic nerve aggravates the further prognosis for the restoration of its lost functions.
Post-traumatic sciatic nerve neuropathy (sciatica) is treated by individually tailoring the treatment for each patient. Treatment of the sciatic nerve (sciatica) includes a set of the following conservative procedures:
- neurostimulation of the sciatic nerve and leg muscles
- vitamins of group "B '," C "and" E "
- homeopathic remedies
- surgical treatment (neurolysis, stitching of the sciatic nerve trunk, etc.)