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ABSTRACT: Far-out syndrome is a rare condition. To our knowledge, this is the first report of far-out syndrome in a hemiplegic patient.
A 57-year-old woman was referred to our hospital with a 4-month history of pain extending from the right buttock to the lateral
area below the knee. She had become left hemiplegic due to a cerebral hemorrhage 5years before her first consultation at
our hospital. Plain films showed right lateral osteophytes of the L5-S1 disk space, which had not been demonstrated on plain
films taken 3years before the onset of cerebral hemorrhage. On computed tomograms (CT) after radiculography, impingement
of the right L5 spinal nerve was observed between lateral osteophytes of L5-S1 and the sacral ala. Since there was no response
to conservative treatment for 5months, resection of the sacral ala only was performed posteriorly via Wiltse's lateral approach.
Just after surgery, complete pain relief was obtained. CT after radiculography would be an alternative imaging study for a
patient with little evidence of impingement on other images. Although it remains speculation, these osteophytes may form from
increased stress on one side versus the other in a hemiplegic patient.
KeywordsLumbosacral spine-Radiculopathy-Far-out syndrome-Hemiplegia
- Department of Orthopedic Surgery
TTJ, Tottori, Japan