title: Piriformis Syndrome and Endoscopic Sciatic Neurolysis.
abstract: Piriformis syndrome is the compression or the irritation of the sciatic nerve by the adjacent piriformis muscle in the buttock leading to symptoms that include buttock pain, leg pain, and altered neurology in the sciatic nerve distribution. Epidemiological figures of the prevalence are unknown, but are estimated to be about 12.2% to 27%. There is no consensus on the diagnostic criteria. Advancement in magnetic resonance imaging allows us to observe unilateral hyperintensity and bowing of the sciatic nerve. The pathophysiology of the disease includes single blunt trauma, overuse causing piriformis hypertrophy, and long-term microtrauma causing scarring. Treatments include physiotherapy, steroid injections, and surgery. Minimally invasive techniques are emerging with the hope that with less postoperative scar tissue formation, there will be less recurrence of the disease. In this chapter, senior author describes his technique for endoscopic sciatic neurolysis.
authors.affiliation: *Millennium Institute of Sport and Health, Rosedale, Auckland, New Zealand †Department of Orthopedics, Division of Sports Medicine, University of Colorado School of Medicine, Aurora, CO.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Knudsen
authors.forename: Omer
authors.initials: O
authors.lastname: Mei-Dan
authors.forename: Mathew J
authors.initials: MJ
authors.lastname: Brick
mesh_terms: D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007273:Injections, Intramuscular; D008279:Magnetic Resonance Imaging; D010808:Physical Examination; D055958:Piriformis Muscle Syndrome / Q000175:diagnosis / Q000601:surgery*; D012584:Sciatic Nerve / Q000601:surgery*; D014221:Triamcinolone / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D014221:Triamcinolone