J Korean Orthop Assoc.  2005 Apr;40(2):143-148.

Sciatic Pain Caused by Piriformis Syndrome

• Lee SU
• Kim KT
• Cho YJ
• Ryu KN
• Chun YS

Abstract

PURPOSE
Sciatic pain rarely develops from piriformis syndrome; thus, its differential diagnosis from other diseases associated with sciatic pain is essential. We analysed the clinical symptoms and radiological findings for the differential diagnosis of piriformis syndrome, and assessed the results of its treatment. MATERIALS AND METHODS: We analysed five patients diagnosed with piriformis syndrome. Four patients were treated with a tenotomy. Of these, three had a history of misdiagnosis. The hypertrophied piriformis muscle was revealed with a compressed sciatic nerve in the operative field. We performed a tenotomy of the piriformis at the site of the tendinous insertion to decompress the sciatic nerve. RESULTS: At the average follow up was 23.5 months, at which time no patients had any problems relating to tenderness and sciatic pain, and were able to return to normal activity one month postoperatively. All patients evaluated their postoperative clinical state as being better. CONCLUSION: Multiple approaches are essential for the diagnosis of piriformis syndrome. We can obtain the satisfactory results through a tenotomy of the piriformis for the decompression of the sciatic nerve in intractable cases as a conservative treatment.

Keyword

Sciatic pain; Piriformis syndrome; Tenotomy

MeSH Terms

Decompression
Diagnosis
Diagnosis, Differential
Diagnostic Errors
Follow-Up Studies
Humans
Piriformis Muscle Syndrome*
Sciatic Nerve
Tenotomy