Perisciatic injection of steroid for the treatment of sciatica due to piriformis syndrome.
OBJECTIVE
Piriformis syndrome causing sciatica is sometimes refractory to conventional treatments including physical therapy, piriformis injections, and even caudal epidural steroid injections. Surgical release of the piriformis muscle has been described for difficult cases of piriformis syndrome, but is occasionally accompanied by morbidity. Another approach to treating piriformis syndrome is presented.


METHODS
A perisciatic injection of steroid using simple landmarks and utilizing a nerve stimulator to locate and inject near the sciatic nerve and into the piriformis muscle is described.


RESULTS
Six patients that did not respond to conventional treatments, but did respond to perisciatic steroid injections are presented. CT scan, in one of the patients, confirmed correct needle placement when this technique and landmarks were used.


CONCLUSIONS
Patients with piriformis syndrome who were refractory to conventional treatments but responded to perisciatic injections of steroid are presented.
Hanania
M
M
Department of Anesthesiology, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA.
Kitain
E
E
D000368:Aged; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications*; D009408:Nerve Compression Syndromes / Q000150:complications*; D012585:Sciatica / Q000188:drug therapy*
D005938:Glucocorticoids; D008775:Methylprednisolone