Robinson, in 1947 introduced for the first time the term 'piriformis syndrome'. More recently, many etiologies of sciatic nerve entrapment around the gluteal region or the non-discogenic area have been identified, resulting in the use of a new term 'The Deep Gluteal Syndrome'. The purpose of this study was to assess the outcomes following the endoscopic release of sciatic nerve entrapment. Type of study is a consecutive case series. Fifteen patients were diagnosed with sciatic nerve entrapment from January 2012 to December 2015, all of them were treated with endoscopic release of the piriformis tendon and sciatic nerve exploration on lateral decubitus position. Every patient had a minimum follow-up to 2 years. The patient-reported outcome scores used included the modified Harris Hip Score (mHHS), pain was estimated on a visual analog scale (VAS) and the Benson outcomes questionnaire. The patient's mean age was 40.2 years (range, 28-50 years). The score improvement from pre-operative to 24-month follow-up was 46.8-84.9 for mHHS ( <0.05). The VAS decreased from pre-operative to 24-month follow-up was 7.4-1.86 ( < 0.05). The Benson outcome ratings were excellent for 11 patients, good for 3 and fair for 1. The Endoscopic Release of the Piriformis Tendon and Sciatic Nerve Exploration showed an improvement of functions, diminishing pain and allowing patients to return to daily activities without symptoms (Level of Evidence: IV).
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http://dx.doi.org/10.1093/jhps/hny018 | DOI Listing |
Plast Reconstr Surg
December 2024
Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Background: Nerve wraps composed of various autologous and bioengineered materials have been used to bolster nerve repair sites. In this study, we describe the novel use of autologous fascia nerve wraps (AFNW) as an adjunct to epineurial repair and evaluate their effect on inflammatory cytokine expression, intraneural collagen deposition and end-organ reinnervation in rats and use of AFNW in a patient case series.
Methods: Lewis rats received sciatic transection with repair either with or without AFNW, sciatic-to-common peroneal nerve transfer with or without AFNW, or sham surgery (n=14/group).
J Orthop Surg Res
December 2024
School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.
Background: Tuina is an effective treatment for the decrease of skeletal muscle atrophy after peripheral nerve injury. However, the underlying mechanism of action remains unclear. This study aimed to explore the underlying mechanisms of tuina in rats with sciatic nerve injury (SNI).
View Article and Find Full Text PDFStem Cell Res Ther
December 2024
Departments of Neurosurgery, The First Center of Chinese, PLA General Hospital, Beijing, China.
Background: Treatment of peripheral nerve defects is a major concern in regenerative medicine. This study therefore aimed to explore the efficacy of a neural graft constructed using adipose mesenchymal stem cells (ADSC), acellular microtissues (MTs), and chitosan in the treatment of peripheral nerve defects.
Methods: Stem cell therapy with acellular MTs provided a suitable microenvironment for axonal regeneration, and compensated for the lack of repair cells in the neural ducts of male 8-week-old Sprague Dawley rats.
Rev Bras Ortop (Sao Paulo)
November 2024
Departmento de Cirurgia Ortopédica, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bolonha, Itália.
A 33-year-old male patient developed distal femur chronic osteomyelitis with massive bone loss after an open grade-3b fracture. Following several failed treatments to eradicate infection, a tibial turn-up procedure was performed to provide a stable and functional stump. To avoid neurovascular problems, the popliteal vessels and sciatic nerve were moved medially, and the flap was rotated externally to decrease the collapse.
View Article and Find Full Text PDFRev Bras Ortop (Sao Paulo)
November 2024
Instituto Vita, São Paulo, São Paulo, Brasil.
Common fibular nerve (CFN) palsy is the most common mononeuropathy in the lower limb, and several etiologies are described. The CFN is the minor and lateral division of the sciatic nerve; it originates in the lumbar sacral division, and many risks of compression have been described: the behavior of crossing and squatting legs, extra and intraneural compressions, local trauma, and weight loss have been increasingly reported as important and noteworthy causes. The treatment is based on the severity of the nerve condition.
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