Pyriformis Syndrome in a 10-Year-old Boy as a Complication of Operation with the Patient in the Sitting Position

Brown, Jeffrey A.; Braun, Marina; Namey, Thomas C.

doi:10.1227/00006123-198807000-00023

Cited by 63 publications

(10 citation statements)

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“…Sciatic nerve deficits and piriformis syndrome have been described after surgery in lithotomy or sitting positions. [47][48][49] CPN is another peripheral nerve in the lower limb that is vulnerable to injury, especially at the neck of the fibula, due to operative positioning, particularly for hip surgery. 50,51 Regardless of the cause, nerve injuries at the level of neurapraxia may give rise to abnormal findings of nerve pathology and regional muscle denervation on MRN as discussed above.…”

Section: Neurapraxiamentioning

confidence: 99%

Peripheral Nerve Surgery: The Role of High-Resolution MR Neurography

Thawait¹,

Wang

Subhawong

et al. 2011

AJNR Am J Neuroradiol

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SUMMARY:High-resolution MRN is becoming increasingly available due to recent technical advancements, including higher magnetic field strengths (eg, 3T), 3D image acquisition, evolution of novel fat-suppression methods, and improved coil design. This review describes the MRN techniques for obtaining high-quality images of the peripheral nerves and their small branches and imaging findings in normal as well as injured nerves with relevant intraoperative correlations. Various microsurgical techniques in peripheral nerves, such as neurolysis, nerve repairs by using nerve grafts, and conduits are discussed, and MRN findings of surgically treated nerves are demonstrated.ABBREVIATIONS: AP ϭ anteroposterior; CPN ϭ common peroneal nerve; IV ϭ intravenous; LPN ϭ lateral plantar nerve; LR ϭ left-to-right; MIP ϭ maximum intensity projection; MPN ϭ medial plantar nerve; MPR ϭ multiplanar reconstruction; MRN ϭ MR neurography; SI ϭ signal intensity; SNR ϭ signal-to-noise ratio; SPACE ϭ sampling perfection with application-optimized contrasts by using different flip angle evolutions; SPAIR ϭ spectral-attenuated inversion recovery; STIR ϭ short tau inversion recovery; T1WI ϭ T1-weighted imaging; T2WI ϭ T2-weighted imaging; TSE ϭ turbo spin-echo

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Section: Neurapraxiamentioning

confidence: 99%

Peripheral Nerve Surgery: The Role of High-Resolution MR Neurography

Thawait¹,

Wang

Subhawong

et al. 2011

AJNR Am J Neuroradiol

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“…Piriformis syndrome most commonly present at fourth to fifth decade of life, 21,[23][24][25][26][27] more commonly in women with gender ratio female: male, 6:1. 3,4,28 It is reported that at least 6% of patients who are diagnosed as having low back pain actually have piriformis syndrome.…”

Section: Epidemiologymentioning

confidence: 99%

Piriformis Syndrome: A Review

Mitra¹,

Roy²,

Dutta³

et al. 2014

jemds

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Piriformis syndrome is a painful musculoskeletal condition resembling sciatica, secondary to sciatic nerve entrapment in piriformis muscle at the greater sciatic notch and responsible for 6%cases of low back pain, also called back pocket sciatica or wallet sciatica, first described in 1928 by Yeoman. It usually occurs due to abnormalities in piriformis muscle such as hypertrophy, inflammation and anatomic variations resulting in irritation and entrapment of sciatic nerve. The diagnosis of piriformis syndrome is made by clinical features, electromyography and nerve conduction velocity, computed tomography, magnetic resonance imaging and bone scan. Management of piriformis syndrome includes nonsurgical and surgical interventions. Non-surgical management includes-nonsteroidal anti-inflammatory drugs, physical therapy, ultrasound, correction of biomechanical abnormality, lifestyle modifications, local anesthetic and/or steroid injection into the piriformis muscle. Surgical management includes-surgical release of piriformis muscle and decompression of the sciatic nerve. Piriformis Syndrome-a review.

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“…Brown et al3) emphasized contributory factors associated with PS including risky sports (e.g., long-distance running, cycling, and horse riding) and professions involving a prolonged seating position (e.g., truck drivers and taxi drivers). The diagnosis of PS is based largely on clinical symptoms, including buttock pain, pain aggravated by sitting, external tenderness near the greater sciatic notch, or physical tests—although they are not specific—when other causes of lumbar discogenic sciatica are excluded 4).…”

mentioning

confidence: 99%

Surgical Treatment of Piriformis Syndrome

Han

Kim

et al. 2017

Clin Orthop Surg

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BackgroundPiriformis syndrome (PS) is an uncommon disease characterized by symptoms resulting from compression/irritation of the sciatic nerve by the piriformis muscle. Uncertainty and controversy remain regarding the proper diagnosis and most effective form of treatment for PS. This study analyzes the diagnostic methods and efficacy of conservative and surgical treatments for PS.MethodsFrom March 2006 to February 2013, we retrospectively reviewed 239 patients who were diagnosed with PS and screened them for eligibility according to our inclusion/exclusion criteria. All patients underwent various conservative treatments initially including activity modification, medications, physical therapy, local steroid injections into the piriformis muscle, and extracorporeal shock wave therapy for at least 3 months. We resected the piriformis muscle with/without neurolysis of the sciatic nerve in 12 patients who had intractable sciatica despite conservative treatment at least for 3 months. The average age of the patients (4 males and 8 females) was 61 years (range, 45 to 71 years). The average duration of symptoms before surgery was 22.1 months (range, 4 to 72 months), and the mean follow-up period was 22.7 months (range, 12 to 43 months). We evaluated the degree of pain and recorded the responses using a visual analog scale (VAS) preoperatively and 3 days and 12 months postoperatively.ResultsButtock pain was more improved than sciatica with various conservative treatments. Compared with preoperatively, the VAS score was significantly decreased after the operation. Overall, satisfactory results were obtained in 10 patients (83%) after surgery.ConclusionsPS is thought to be an exclusively clinical diagnosis, and if the diagnosis is performed correctly, surgery can be a good treatment option in patients with refractory sciatica despite appropriate conservative treatments.

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Pyriformis Syndrome in a 10-Year-old Boy as a Complication of Operation with the Patient in the Sitting Position

Cited by 63 publications

References 0 publications

Peripheral Nerve Surgery: The Role of High-Resolution MR Neurography

Peripheral Nerve Surgery: The Role of High-Resolution MR Neurography

Piriformis Syndrome: A Review

Surgical Treatment of Piriformis Syndrome

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