Inferior and superior gluteal nerve paresis and femur neck fracture after spondylolisthesis and lysis: a case report.

ABSTRACT

A 33-year-old woman is presented with spondylolisthesis of L4 on L5 with osteolysis of the L4 vertebra, left-sided superior and inferior gluteal nerve paresis and a fracture of the neck of the left femur. The gluteal muscle paresis was thought to be caused by an entrapment of the gluteal nerves through the piriformis muscle, as a consequence of the lumbar lordosis and inadequate stabilization of the back. The femoral fracture was explained by lack of the compensating action of the paretic gluteal muscles, through which an abnormal strain on the femoral neck occurred while climbing a staircase. Innervation disturbance of the superior part of the femoral neck, which is normally innervated by the superior gluteal nerve, might also be a causative factor in the occurrence of this fracture.