No abstract available.
Piriformis Muscle Syndrome*

Acupuncture Therapy ; instrumentation ; Adult ; Female ; Humans ; Male ; Middle Aged ; Muscle Strength ; Piriformis Muscle Syndrome ; physiopathology ; therapy

BACKGROUND: Motor weakness occurs frequently after piriformis injection and it could put patients at risk of falls. We investigated the appropriate concentration and volume of ropivacaine required to minimize motor dysfunction. METHODS: A total of 120 patients who received piriformis injection were included in this study. Piriformis injections of triamcinolone 10 mg in various concentrations (0.1%, 0.075%) and volumes (8, 10, 12 ml) of ropivacaine were administered in 20 patients, respectively. One hour after the injection, we compared motor function according to the concentrations and volumes of ropivacaine. RESULTS: There were significant differences (P < 0.05) in the occurrence of motor dysfunction according to body mass index (BMI) and the concentration of ropivacaine. No significant differences were found in terms of gender, age, weight, height, or the volume of ropivacaine. Logistic regression analysis showed that the likelihood of motor dysfunction with administration of 0.1% ropivacaine was 58.249 times greater than that with administration of 0.075% concentration (P < 0.001), while BMI did not have a significant effect on motor dysfunction. CONCLUSIONS: According to the results of this study, 0.075% ropivacaine rather than 0.1% ropivacaine is appropriate in terms of reducing motor dysfunction after piriformis injection.
Accidental Falls ; Body Mass Index ; Humans ; Logistic Models ; Piriformis Muscle Syndrome ; Triamcinolone

The piriformis syndrome is a condition allegedly attributable to compression of the sciatic nerve by the piriformis muscle. Recently, magnetic resonance neurography and electrophysiologic study have helped to diagnose piriformis syndrome. High dose radiotherapy could induce acute and delayed muscle damage. We had experienced piriformis syndrome with fatty atrophy of piriformis muscle after radiotherapy for recurrent cervical cancer.
Atrophy ; Magnetic Resonance Spectroscopy ; Muscles ; Piriformis Muscle Syndrome ; Sciatic Nerve ; Sciatic Neuropathy ; Uterine Cervical Neoplasms

BACKGROUND: The objective was to evaluate the distance from the skin and the diameter of the piriformis muscle and their relationship to the body mass index (BMI). METHODS: The study was a prospective study involving 60 patients. Patients were prepared on a radiological table in the prone position. Several images were obtained of each. In this view, the distance between the subcutaneous tissue and the piriformis muscle, and the diameter of the piriformis, were measured at three points (medially to laterally). RESULTS: The distance to the piriformis from the skin was 6.6 +/- 0.9 cm, 6.3 +/- 0.8 cm, and 5.2 +/- 0.9 cm in terms of the lateral, center, and medial measurement, respectively. The center of the piriformis had a greater diameter with 1.7 +/- 0.4 (0.9-2.5) cm. The distance to the piriformis increased with BMI. CONCLUSIONS: This study shows that the lateral of the piriformis muscle has a relatively greater distance from the skin. The center of the piriformis showed a greater diameter than other two portions. We found that the distance of the piriformis from subcutaneous tissues was correlated with BMI, but the diameter of the piriformis was not affected by BMI. These measurements can be used as a reference for determining the piriformis injection site in patients with piriformis syndrome.
Body Mass Index ; Humans ; Muscles ; Piriformis Muscle Syndrome ; Prone Position ; Prospective Studies ; Skin ; Subcutaneous Tissue

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

The most common cause of pain in the distribution of sciatic nerve is a herniated lumbar disc, Spinal stenosis, intrapelvic masses, and diabetic neuropathy may also produce scitica-like symptom. Infrequently, Piriformis syndrome is a rare disease causing sciatica produced by entrapment of sciatic nerve by the piriformis muscle as it passes through the sciatic notch. Recently we experienced a case of piriformis syndrome to be successfully treated by exploration of sciatic nerve and sectioning of fibrous band between piriformis muscle and gluteus maximus muscle. We would describe the clinical feature of a piriformis syndrome, and review other literatures.
Diabetic Neuropathies ; Piriformis Muscle Syndrome* ; Rare Diseases ; Sciatic Nerve ; Sciatica ; Spinal Stenosis

PURPOSE: The purpose of this study was to evaluate the long-term efficacy of ultrasound (US)-guided steroid injections in patients with piriformis syndrome. METHODS: Between January 2010 and October 2012, 63 patients (23 men and 40 women; average age, 63.2 years; range, 24 to 90 years) were diagnosed with piriformis syndrome based on clinical history, electromyography, and flexion-adduction-internal rotation test results. They were divided into two groups. The first group (37 subjects) received a US-guided steroid injection around the piriformis muscle. The second group (26 subjects) received both piriformis muscle and spinal epidural injections. The therapeutic effect was categorized as improvement, partial improvement, or failure depending on the degree of symptom alleviation one month after injection, based on a review of each patient's medical records. RESULTS: In the first group, 15 patients (40.5%) showed improvement, seven (18.9%) showed partial improvement, and 15 (40.5%) failed to respond to the initial treatment. In the second group, eight patients (30.8%) showed improvement, 11 (42.3%) showed partial improvement, and seven (26.9%) failed to respond to the initial treatment. A second piriformis injection was performed in four cases, after which two patients showed improvement within 3 years, but the other two showed no therapeutic effect. CONCLUSION: US-guided steroid injection may be an effective treatment option for patients with piriformis syndrome.
Electromyography ; Female ; Humans ; Injections, Epidural ; Male ; Medical Records ; Piriformis Muscle Syndrome* ; Steroids ; Ultrasonography

The piriformis syndome is a rare condition characterized by pain and paresthesia in the buttock, often radiating to the posterior thigh. Symptoms are made worse by hip adduction and internal rotation of the hip joint. We report two cases of piriformis syndrome caused by an atypical sciatic nerve pathway combined with hamstring hypertrophy.
Buttocks ; Hip ; Hip Joint ; Hypertrophy ; Paresthesia ; Piriformis Muscle Syndrome* ; Sciatic Nerve ; Thigh

As the expertise of the surgeon improves in arthroscopic surgery of the hip, the number of conditions treated by it also increases. In this case, an arthroscopic treatment was performed on a patient with piriformis syndrome due to schwannoma on the sciatic nerve. Meticulous excision of the cystic lesion on the sciatic nerve was completely performed and neither recurrence nor complication of the surgery was observed. Endoscopic excision using arthroscopy is useful for reducing postoperative pain and achieving early return to activities for the patient.
Arthroscopy* ; Hip* ; Humans ; Neurilemmoma* ; Pain, Postoperative ; Piriformis Muscle Syndrome ; Recurrence ; Sciatic Nerve*