Piriformis and related entrapment syndromes: myth & fallacy.
This article explores the myths surrounding piriformis syndrome. It looks at the syndrome's history ranging from early hypothesis to acceptance; then from disfavor to resurrection as a diagnosis for patients with leg pain devoid of objective neurologic deficits, without disc herniations. It includes a critical review of the clinical literature and treatment strategies. It calls for a renaming of the syndrome to "nonlocalizing sciatica" and restriction of surgical resection of the piriformis to cases where all other treatment has failed. This is part of a Point-Counterpoint discussion with Dr. Aaron Filler's presentation of "Diagnosis and Management".
Tiel
Robert L
RL
Department of Neurosurgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA. rtiel@neurosurgery.umsmed.edu
D000777:Anesthetics; D001905:Botulinum Toxins / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed
D000777:Anesthetics; D001905:Botulinum Toxins