Point d’anatomie. Focus sur le syndrome du piriforme : étiologie, test et niveaux de preuve. L’anatomie au service de la clinique

Dufour, Xavier; Evelinger, Stéphane; Cerioli, Arnaud

doi:10.1016/j.kine.2017.07.001

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…A síndrome do piriforme, como causa do quadro clínico de ciatalgia, continua actualmente a suscitar estudos internacionais e tentativas de modernização da abordagem clínica. 40,41,42 A hipótese de maior frequência de agenésia ou trajecto curto do tronco do nervo isquiático pode colocar importantes ilações clínicas e cirúrgicas, 39 como no caso de bloqueios anestésicos, 37,44 na terapêutica conservadora da ciatalgia, 45 e também sobretudo nos procedimentos técnicos e seguimento clínico de casos de artroplastia da anca, 36,39,[43][44][45] cujo número crescente se deve ao envelhecimento gradual da população, para além do crescimento da cobertura populacional mundial em termos de cuidados de saúde.…”

Section: Inferiorunclassified

Repensar a Ciatalgia Perante Variação Anatómica Bilateral do Nervo Isquiático, com Origem Baixa e Divisão Alta: Importância Histórica, Anatómica e Clínica

Ribeiro¹,

Bettencourt-Pires²,

Silva³

et al. 2018

Acta Med Port

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Introduction: The aim of the present study is to report an original, unusual, case of bilateral anatomical variation of the sciatic nerve, with low origin and high division.Material and Methods: Anatomical dissection was performed on a 66 year-old female cadaver. The corpse was embalmed and conserved through our original embalming techniques.Results: The particular anatomical variation was first detected during routine dissection classes for undergraduate students. The study was completed with contralateral dissection to unveil bilateral variation. In both hind limbs, the sciatic nerve had a low origin, deep below the mid-gluteal region, and suffered high division, near the lower margin of the gluteal region, after a short length of circa 8 cm, to divide into the common fibular and tibial nerves.Discussion: We detect several cases of sciatic nerve high division, in the reports of the earliest anatomists, such as Leonardo da Vinci, Vesalius, Da Cortona, or Eustachius. Such ancestral interest for these anatomical variations demonstrates the importance of their knowledge for health professionals of different areas.Conclusion: The accurate study of sciatic nerve anatomical variations bears evident surgical, anaesthesiology and clinical applications. As more meticulous as our anatomical studies may get, one will never reach the state of perfection to consider such studies as definitive.

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Section: Inferiorunclassified

Repensar a Ciatalgia Perante Variação Anatómica Bilateral do Nervo Isquiático, com Origem Baixa e Divisão Alta: Importância Histórica, Anatómica e Clínica

Ribeiro¹,

Bettencourt-Pires²,

Silva³

et al. 2018

Acta Med Port

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“…The piriformis is a flat isosceles triangle-shaped muscle of the gluteo-pelvic region contributing to hip extension, lateral hip rotation, hip abduction, and stabilizing of the hip joint [ 9 , 31 ]. The origin of the muscle is variable.…”

Section: Introductionmentioning

confidence: 99%

Novel anatomical findings with implications on the etiology of the piriformis syndrome

2022

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Purpose The cause of the piriformis-related pelvic and extra-pelvic pain syndromes is still not well understood. Usually, the piriformis syndrome is seen as extra-pelvic sciatica caused by the entrapment of the sciatic nerve by the piriformis in its crossing through the greater sciatic foramen. However, the piriformis muscle may compress additional nerve structures in other regions and cause idiotypic pelvic pain, pelvic visceral pain, pudendal neuralgia, and pelvic organ dysfunction. There is still a lack of detailed description of the muscle origin, topography, and its possible relationships with the anterior branches of the sacral spinal nerves and with the sacral plexus. In this research, we aimed to characterize the topographic relationship of the piriformis with its surrounding anatomical structures, especially the anterior branches of the sacral spinal nerves and the sacral plexus in the pelvic cavity, as well as to estimate the possible role of anatomical piriformis variants in pelvic pain and extra-pelvic sciatica. Methods Human cadaveric material was used accordingly to the Swiss Academy of Medical Science Guidelines adapted in 2021 and the Federal Act on Research involving Human Beings (Human Research ACT, HRA, status as 26, May 2021). All body donors gave written consent for using their bodies for teaching and research. 14 males and 26 females were included in this study. The age range varied from 64 to 97 years (mean 84 ± 10.7 years, median 88). Results three variants of the sacral origin of the piriformis were found when referring to the relationship between the muscle and the anterior sacral foramen. Firstly, the medial muscle origin pattern and its complete covering of the anterior sacral foramen by the piriformis muscle is the most frequent anatomical variation (43% in males, 70% in females), probably with the most relevant clinical impact. This pattern may result in the compression of the anterior branches of the sacral spinal nerves when crossing the muscle. Conclusions These new anatomical findings may provide a better understanding of the complex piriformis and pelvic pain syndromes due to compression of the sacral spinal nerves with their somatic or autonomous (parasympathetic) qualities when crossing the piriformis.

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Point d’anatomie. Focus sur le nerf sciatique et l’élévation jambe tendue : étiologie, test et niveaux de preuve. L’anatomie au service de la clinique

Evelinger¹,

Dufour²,

Cerioli³

2018

Kinésithérapie, la Revue

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Point d’anatomie. Focus sur le syndrome du piriforme : étiologie, test et niveaux de preuve. L’anatomie au service de la clinique

Cited by 3 publications

References 16 publications

Repensar a Ciatalgia Perante Variação Anatómica Bilateral do Nervo Isquiático, com Origem Baixa e Divisão Alta: Importância Histórica, Anatómica e Clínica

Repensar a Ciatalgia Perante Variação Anatómica Bilateral do Nervo Isquiático, com Origem Baixa e Divisão Alta: Importância Histórica, Anatómica e Clínica

Novel anatomical findings with implications on the etiology of the piriformis syndrome

Point d’anatomie. Focus sur le nerf sciatique et l’élévation jambe tendue : étiologie, test et niveaux de preuve. L’anatomie au service de la clinique

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