Recurrent Piriformis Syndrome After Surgical Release

Abstract

Piriformis syndrome is an uncommon condition characterized by sciatic nerve entrapment at the greater sciatic notch. Nonoperative treatment such as physical therapy, nonsteroidal antiinflammatory drugs, and local injections often results in relief of symptoms. For patients who do not benefit from nonoperative therapy, surgical exploration and decompression of the sciatic nerve has been effective. However, the success of surgery may be diminished by scar formation or hematoma in the anatomically restricted sciatic notch. We report two patients with piriformis syndrome who responded primarily to surgical decompression and had recurrent symptoms resulting from scar tissue formation in the sciatic notch. On revision surgery, polytetrafluoroethylene pledgets were placed around the sciatic nerve to avoid compression and entrapment by scar tissue. Both patients had satisfactory outcomes at 3 years followup.

Piriformis muscle syndrome: a recurrent case after surgical release

“…Surgical release is considered for individuals who do not respond to conservative methods. Recurrence after surgery for Piriformis muscle syndrome has been reported by Kobbe et al [ 2 ], and to the best of our knowledge, this is the second study addressing this subject.…”

“…To the best of our knowledge, recurrent piriformis syndrome has been documented by Kobbe et al [ 2 ]. Our patient similar to the cases reported by Kobbe et al [ 2 ] had an anatomical variation of piriformis muscle and sciatic nerve.…”

“…To the best of our knowledge, recurrent piriformis syndrome has been documented by Kobbe et al [ 2 ]. Our patient similar to the cases reported by Kobbe et al [ 2 ] had an anatomical variation of piriformis muscle and sciatic nerve. During revision surgeries performed by Kobbe et al , scar tissues around sciatic nerve were encountered and released, the same finding that was observed during our revision surgery.…”

Does endoscopic piriformis tenotomy provide safe and complete tendon release? A cadaver study

“…La ténotomie peut également se faire à ciel ouvert [6][7][8][9][10] avec un abord postérieur de la hanche. En plus du préjudice esthétique après décompression chirurgicale à ciel ouvert, Kobbe et al [16] rapportaient deux cas de récurrence de la symptomatologie causée par la formation de fibrose dans l'échancrure ischiatique. Aucune étude ne compare les résultats des deux techniques, aussi il est difficile de juger des avantages et inconvénients de chacune.…”

Arthroscopic treatment of piriformis syndrome by perineural cyst on the sciatic nerve: a case report

“…Posterior approach was used for traditional method, but it had to make a longer skin incision than our case for exposure of the piriformis muscle. After these traditional incisions, Kobbe et al [7] reported two cases of symptom recurrence after surgical decompression caused by scar formation of sciatic notch.…”