Piriformis muscle syndrome in 19 patients treated by tenotomy - A 1- to 16-year follow-up study

Indrekvam, Kari; Sudmann, Einar

doi:10.1007/s00264-001-0319-z

Cited by 41 publications

(3 citation statements)

References 24 publications

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“…The largest cohorts were published by Fishman et al . [ 18 ], Indrekvam and Sudmann [ 19 ] and Benson and Schutzer [ 17 ]. The results from these three studies, respectively, ranged from 68.8% achieving >50% relief, two thirds improved and 100% excellent or good results.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic release of the piriformis tendon and sciatic nerve exploration

Ilizaliturri

Arriaga

Villalobos

et al. 2018

Journal of Hip Preservation Surgery

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Robinson, in 1947 introduced for the first time the term ‘piriformis syndrome’. More recently, many etiologies of sciatic nerve entrapment around the gluteal region or the non-discogenic area have been identified, resulting in the use of a new term ‘The Deep Gluteal Syndrome’. The purpose of this study was to assess the outcomes following the endoscopic release of sciatic nerve entrapment. Type of study is a consecutive case series. Fifteen patients were diagnosed with sciatic nerve entrapment from January 2012 to December 2015, all of them were treated with endoscopic release of the piriformis tendon and sciatic nerve exploration on lateral decubitus position. Every patient had a minimum follow-up to 2 years. The patient-reported outcome scores used included the modified Harris Hip Score (mHHS), pain was estimated on a visual analog scale (VAS) and the Benson outcomes questionnaire. The patient’s mean age was 40.2 years (range, 28–50 years). The score improvement from pre-operative to 24-month follow-up was 46.8–84.9 for mHHS (P <0.05). The VAS decreased from pre-operative to 24-month follow-up was 7.4–1.86 (P < 0.05). The Benson outcome ratings were excellent for 11 patients, good for 3 and fair for 1. The Endoscopic Release of the Piriformis Tendon and Sciatic Nerve Exploration showed an improvement of functions, diminishing pain and allowing patients to return to daily activities without symptoms (Level of Evidence: IV).

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Section: Discussionmentioning

confidence: 99%

Endoscopic release of the piriformis tendon and sciatic nerve exploration

Ilizaliturri

Arriaga

Villalobos

et al. 2018

Journal of Hip Preservation Surgery

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“…Adequate exposure of the proximal portion of the sciatic nerve is guaranteed with the transgluteal approach. Even though this has been accomplished for compressive lesions using much smaller skin incisions elsewhere,[ 3 6 18 22 ] in traumatic injuries, as in our series, wider exposure is needed.…”

Section: Discussionmentioning

confidence: 99%

Exposure of the sciatic nerve in the gluteal region without sectioning the gluteus maximus: Analysis of a series of 18 cases

Socolovsky¹,

Masi²

2012

Surg Neurol Int

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Background:Dissecting through the gluteus maximus muscle by splitting its fibers, instead of complete sectioning of the muscle, is faster, involves less damage to tissues, and diminishes recovery time. The objective of the current paper is to present a clinical series of sciatic nerve lesions where the nerve was sufficiently exposed via the transgluteal approach.Methods:We retrospectively selected 18 traumatic sciatic nerve lesions within the buttock, operated upon from January 2005 to December 2009, with a minimum follow-up of 2 years. In all patients, a transgluteal approach was employed to explore and reconstruct the nerve.Results:Ten males and eight females, with a mean age of 39.7 years, were studied. The etiology of the nerve lesion was previous hip surgery (n = 7), stab wound (n = 4), gunshot wound (n = 3), injection (n = 3), and hip dislocation (n = 1). In 15 (83.3%) cases, a motor deficit was present; in 12 (66.6%) cases neuropathic pain and in 12 (66.6%) cases sensory alterations were present. In all cases, the transgluteal approach was adequate to expose the injury and treat it by neurolysis alone (10 cases), neurolysis and neurorrhaphy (4 cases), and reconstruction with grafts (4 cases; three of these paired with neurolysis). The mean pre- and postoperative grades for the tibial nerve (LSUHSC scale) were 1.6 and 3.6, respectively; meanwhile, for the peroneal division, preoperative grade was 1.2 and postoperative grade was 2.4.Conclusions:The transgluteal approach adequately exposes sciatic nerve injuries of traumatic origin in the buttock and allows for adequate nerve reconstruction without sectioning the gluteus maximus muscle.

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“…The reports in the literature are varied; most are case reports and small series with variable results. The largest cohorts were published by Fishman et al., 8 Indrekvam and Sudmann, 12 and Benson and Schutzer. 13 The results from these 3 studies showed an improvement achieving more than 50% symptom relief.…”

Section: Discussionmentioning

confidence: 99%