Case report : recurrent piriformis syndrome after surgical release.
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.
Kobbe
Philipp
P
Department of Orthopaedic Surgery, Division of Trauma, University of Pittsburgh School of Medicine, Kaufmann Building, Suite 1010, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA. kobbep@upmc.edu
Zelle
Boris A
BA
Gruen
Garry S
GS
D000328:Adult; D001672:Biocompatible Materials; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery*; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011138:Polytetrafluoroethylene; D012008:Recurrence; D012086:Reoperation; D020426:Sciatic Neuropathy / Q000601:surgery*
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene