Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\28567214
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Orthop+Surg
2017 ; 9
(2
): 136-144
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Surgical Treatment of Piriformis Syndrome
#MMPMID28567214
Han SK
; Kim YS
; Kim TH
; Kang SH
Clin Orthop Surg
2017[Jun]; 9
(2
): 136-144
PMID28567214
show ga
BACKGROUND: Piriformis 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.
METHODS: From 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. RESULTS:
Buttock 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. CONCLUSIONS: PS 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.