title: CT-guided piriformis muscle injection for the treatment of piriformis syndrome.
abstract: OBJECTIVE
  Piriformis syndrome is a rare neuromuscular disorder that occurs when the piriformis muscle compresses or irritates the sciatic nerve. The treatment of piriformis syndrome includes injections into the piriformis muscle around the sciatic nerve. These invasive approaches have been used with various techniques to increase the safety of the procedure. Computed tomography (CT)-guided injection of the piriformis muscle and the clinical outcome of the patients are discussed.
  
  
  METHODS
  The authors presented 10 consecutive patients that underwent CT-guided piriformis injection between March and December 2007. Three patients had a history of a severe fall on the buttocks, one had gluteal abscess formation following deep intramuscular injection, and another one had a habit of prolonged sitting on the carpet. Etiology was not identified in the other patients. Main complaints of the patients were pain and numbness in the legs. Hypesthesia was the major neurological finding. Magnetic resonance imaging (MRI) and electromyography (EMG) were performed in all patients.
  
  
  RESULTS
  Nine patients had full and sustained recovery of their symptoms after piriformis injection. Only the patient who had gluteal abscess formation following deep intramuscular injection showed moderate improvement. Another patient was operated on in the 6th month after piriformis injection due to an extruded disc herniation.
  
  
  CONCLUSIONS
  CT-guided piriformis injection is a safe and effective method in the treatment of piriformis syndrome.
authors: TDV 29 Mayis Hospital, Department of Neurosurgery, Ankara, Turkey.
authors: Pinar Akdemir
authors: PA
authors: Ozisik
authors: Mustafa
authors: M
authors: Toru
authors: C Cem
authors: CC
authors: Denk
authors: Ozden O
authors: OO
authors: Taskiran
authors: Begum
authors: B
authors: Gundogmus
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D004576:Electromyography; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009120:Muscle Cramp / Q000209:etiology; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D009460:Neurologic Examination; D055958:Piriformis Muscle Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods*; D012585:Sciatica / Q000628:therapy
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D008775:Methylprednisolone; D002045:Bupivacaine