scholarly journals Minimal Invazive Surgical Treatment of Piriformis Syndrome and the Results

2019 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Conservative Treatment ◽  
Surgical Procedures ◽  
Pain Syndrome ◽  
Anatomical Variations ◽  
Clinical Findings ◽  
Piriformis Syndrome ◽  
Minimally Invasive Surgical ◽  
Magnetic Resonance Imaging Mri

Piriformis syndrome is a neuromuscular pain syndrome occurring as a result of compression on the underlying sciatic nerve due to various causes including the hypertrophy, inflammation, mass lesions or anatomical variations occuring in the deep gluteal space. Patients with piriformis syndrome often experience pain and numbness in the hip, thigh and leg, similar to those of sciatica. In addition to clinical findings, electrophysiological examinations and magnetic resonance imaging (MRI) is useful for diagnosis. Once diagnosed, the treatment approach is stepwise and conservative treatment is successful in majority of cases. Surgical treatment should be performed for the cases in whom conservative treatment methods fail and when the sciatic nerve should be decompressed. Surgery is an important treatment option for unresolved piriformis syndrome with its simplicity and low morbidity. Several surgical procedures have been described for the decompression of affected sciatic nerve. Due to excessive fibrosis tissue that may be developed around the sciatic nerve in classical surgical procedures, person's return to social and work life may be delayed. In the present study, we will evaluate the surgical indication criteria of our cases who underwent minimally invasive surgical treatment due to piriformis syndrome, the definition of the surgical procedure and the outcomes.

scholarly journals Minimally invasive surgery for spine osteomyelitis treatment

2021 ◽  
pp. 104-110
Author(s):  
Ye.Ya. Kochnev ◽  
◽  
S.Vl. Lyulin ◽  
S.V. Mukhtyaev ◽  
I.A. Meshcheryagina ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Surgical Intervention ◽  
Life Quality ◽  
Pain Syndrome ◽  
Minimally Invasive Surgical ◽  
Minimally Invasive Surgical Treatment

The aim of the research is to study the results of minimally invasive surgery for the treatment of nonspecifi c infectious spine lesions, and to present personal experience. Material and methods. Three patients with purulent nonspecifi c spondylodiscitis of lumbar spine got minimally invasive surgical treatment. The essence of surgical intervention included X-ray-assisted placement of tubular retractors in the area of intervertebral disc aff ected by purulent process; debridement and irrigation with antiseptic solution of interbody space, and setting a drain tube. All patients were treated during the period from December 2016 to February 2019. They were examined before surgery and in 3 months aft er the discharge. Laboratory parameters (CBT, C-reactive protein, bacteriological analysis of intervertebral disc contents) and instrumental research methods (computer tomography, magnetic resonance imaging) were evaluated. ODI, VAS, SF-36 questionnaires helped to assess pain syndrome and life quality of patients. Results. In 100 % of studied cases infection was caused by Staphylococcus aureus. The result of treatment in all cases was assessed as good, because pain syndrome, neurological disorders and inflammatory process were arrested; there were no signs of disease progression. In all cases, life quality of patients was restored. In one case, additional surgical intervention was required (posterior instrumental fi xation of spine) because of instability signs. Conclusion. Minimally invasive surgical treatment of purulent single-level spondylodiscites can be recommended for practical use. The use of such approache allows to verify purulent infection agent, to damage soft tissues less getting proper sanitation of interbody space. It also allows to stop the infection and restore life quality of a patient

scholarly journals Facet syndrome. Minimally invasive surgical treatment. (Clinical case with a literature re-view).

2021 ◽  
Author(s):  
Vitaliy E. Potapov ◽  
Vladimir Alekseevich Sorokovikov ◽  
Sergey Nikolaevich Larionov ◽  
Aleksandr Petrovich Zhivotenko
Keyword(s):  
Surgical Treatment ◽  
Facet Joint ◽  
Pain Syndrome ◽  
Intervertebral Discs ◽  
Facet Joints ◽  
Spinal Motion ◽  
Minimally Invasive Surgical ◽  
High Incidence ◽  
Facet Syndrome ◽  
Minimally Invasive Surgical Treatment

The problem of the pathology of the facet joints of the lumbar spine remains significant and is medical and social due to persistent pain syndrome, high incidence of morbidity and frequent disability outcomes. The complex anatomical and topographic relationships of the facet joints, intervertebral discs and radicular nerves force clinicians to pay attention to the pathology of facet syndrome. A pair of facet joints and an intervertebral disc constitute a functional unit - a "three-component complex" and are interconnected with each other. The article examines the anatomical and morphological features and radiological classifications of degenerative changes in the facet joints, which are currently used in clinical practice. Facet joint pathologies are the most common nosological form of degenerative-dystrophic process (spondyloarthrosis) and a potential source of pain with the formation of instability of the spinal motion segment and the formation of chronic pain syndrome. The features of facet syndrome diagnostics are presented on a clinical example of surgical treatment by means of laser dereception of facet joints.

scholarly journals Optimization of Surgical Care and Anesthesia in the Treatment of Multilevel Degenerative Diseases of the Lumbar Spine in Patients with Overweight and Obesity

2018 ◽  
Vol 73 (6) ◽  
pp. 401-410 ◽  
Author(s):  
Vadim A. Byvaltsev ◽  
Andrey A. Kalinin ◽  
Victoria Yu. Goloborodko
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
Surgical Care ◽  
Pain Syndrome ◽  
Overweight And Obesity ◽  
Degenerative Diseases ◽  
Minimally Invasive Surgical ◽  
Paravertebral Muscles

Background: The provision of surgical care in the treatment of degenerative diseases of the lumbar spine in patients with obesity and obesity is associated with significant risks of anesthesia and the development of perioperative complications. Aims: to analyze the results of the introduction of a combination of surgical procedures and anesthesia in the treatment of multilevel degenerative diseases of the lumbar spine in patients with excessive body weight and obesity.Materials and methods: The results of surgical treatment of 86 patients were studied, 2 groups were identified. In the study group (SG, n=37), minimally invasive surgical techniques and original surgical approach, paravertebral musculature infiltration with bupivacaine with epinephrine, and multimodal anesthesia with dexmedetomidine were used. The comparison group (CG, n=49) consisted of patients who used the technique of traditional open transpedicular fixation in combination with the posterior interbody fusion without the above combination of surgical procedures and anesthesia. Observation and clinical evaluation was performed in the early (during hospitalization) and in the distant (on average 36 months) postoperative periods.Results: In SG there were no changes in hemodynamics and better results were obtained on the speed of recovery of psychomotor functions. The use of local anesthetics significantly reduced the local pain syndrome (p0.05) and the need for analgesics (p=0.002). Comparative analysis in the main group revealed significantly better results in indices of the duration of the operation [SG 145 (105; 155) min, CG 185 (100; 205) min; p=0.02], the volume of blood loss [SG 110 (90; 140) ml, CG 510 (390; 640) ml; p0.001], the activation time [SG 1 (1; 2) days, CG 3 (3; 4) days; p=0.01], the length of hospitalization [SG 10 (9; 11) days, CG 13 (12; 15) days; p=0,03], remote clinical parameters of the pain syndrome level from the visual analogue scale in the lower extremities [SG 3 (1; 4) mm, CG 9 (6; 14) mm; p=0.006] and the lumbar spine [SG 6 (4; 9) mm, CG 16 (11; 21) mm; p=0.001], functional state according to ODI [SG 8 (6; 10) points, CG 16 (12; 24) points; p=0.008], subjective satisfaction with the operation performed on the Macnab scale (p=0.01). The number of postoperative complications in SG was 8%, in CG ― 18% (p=0.006).Conclusions: Analysis of the results of the introduction of a combination of surgical and anesthetic support methods in the treatment of multilevel degenerative diseases of the lumbar spine in patients with overweight and obesity, including minimally invasive surgical techniques, infiltration of paravertebral muscles with bupivacaine and epinephrine, multimodal anesthesia with dexmedetomidine showed its high perioperative safety, low number of complications, as well as better and clinical outcomes in the early and late postoperative periods.

Piriformis Syndrome

2003 ◽  
Vol 98 (6) ◽  
pp. 1442-1448 ◽  
Author(s):  
Honorio T. Benzon ◽  
Jeffrey A. Katz ◽  
Hubert A. Benzon ◽  
Muhammad S. Iqbal
Keyword(s):  
Sciatic Nerve ◽  
Pain Syndrome ◽  
Needle Insertion ◽  
Cadaver Study ◽  
Failed Back Surgery Syndrome ◽  
Herniated Disc ◽  
Piriformis Syndrome ◽  
Piriformis Muscle ◽  
Lower Border ◽  
Failed Back Surgery

Background Piriformis syndrome can be caused by anatomic abnormalities. The treatments of piriformis syndrome include the injection of steroid into the piriformis muscle and near the area of the sciatic nerve. These techniques use either fluoroscopy and muscle electromyography to identify the piriformis muscle or a nerve stimulator to stimulate the sciatic nerve. Methods The authors performed a cadaver study and noted anatomic variations of the piriformis muscle and sciatic nerve. To standardize their technique of injection, they also noted the distance from the lower border of the sacroiliac joint (SIJ) to the sciatic nerve. They retrospectively reviewed the charts of 19 patients who had received piriformis muscle injections, noting the site of needle insertion in terms of the distance from the lower border of the SIJ and the depth of needle insertion at which the motor response of the foot was elicited. The authors tabulated the response of the patients to the injection, any associated diagnoses, and previous treatments that these patients had before the injection. Finally, they reviewed the literature on piriformis syndrome, a rare cause of buttock pain and sciatica. Results In the cadavers, the distance from the lower border of the SIJ to the sciatic nerve was 2.9 +/- 0.6 (1.8-3.7) cm laterally and 0.7 +/- 0.7 (0.0-2.5) cm caudally. In 65 specimens, the sciatic nerve passed anterior and inferior to the piriformis. In one specimen, the muscle was bipartite and the two components of the sciatic nerve were separate, with the tibial nerve passing below the piriformis and the peroneal nerve passing between the two components of the muscle. In the patients who received the injections, the site of needle insertion was 1.5 +/- 0.8 (0.4-3.0) cm lateral and 1.2 +/- 0.6 (0.5-2.0) cm caudal to the lower border of the SIJ as seen on fluoroscopy. The needle was inserted at a depth of 9.2 +/- 1.5 (7.5-13.0) cm to stimulate the sciatic nerve. Patients had comorbid etiologies including herniated disc, failed back surgery syndrome, spinal stenosis, facet syndrome, SIJ dysfunction, and complex regional pain syndrome. Sixteen of the 19 patients responded to the injection, their improvements ranged from a few hours to 3 months. Conclusions Anatomic abnormalities causing piriformis syndrome are rare. The technique used in the current study was successful in injecting the medications near the area of the sciatic nerve and into the piriformis muscle.

Possibility of Treating Lumbar Spice Pain Syndrome

2018 ◽  
Vol 1 (2) ◽  
pp. 28-34
Author(s):  
Jarosław JASIĘGA ◽  
Andrzej PERMODA
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Diagnostic Tests ◽  
Pain Syndrome ◽  
Spinal Pain ◽  
Spinal Pain Syndrome

Causes of spinal pain syndrome are very c o m p l e x . T h e i r g e n e s i s i s multidimensional and therefore should diversify the implemented recovery p r o c e e d i n g s . Mo s t c o m m o n l y recommended types of therapy include i n i t i a l l y d i f f e r e n t m e t h o d s o f conservative treatment. Only after exhausting their possibilities a patient may undergo a surgical treatment. Surgical treatment may be a necessity from the very beginning with the obvious results of the diagnostic tests.

scholarly journals SURGICAL TREATMENT OF PERIPHERAL NERVES COMBAT WOUNDS OF THE EXTREMITIES

2021 ◽  
Vol 74 (3) ◽  
pp. 619-624
Author(s):  
Vitalii I. Tsymbaliuk ◽  
Sergii S. Strafun ◽  
Ihor B. Tretyak ◽  
Iaroslav V. Tsymbaliuk ◽  
Alexander A. Gatskiy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Pain Syndrome ◽  
Common Peroneal Nerve ◽  
Combat Trauma ◽  
Diagnostic Measures ◽  
Combat Injuries ◽  
Recovery Of Motor Function ◽  
Degree Of Recovery

The aim: Improving the effectiveness of patients' treatment with combat injuries of the peripheral nervous system, which consists in the application and development of new methods of reconstructive interventions, optimizing a set of therapeutic and diagnostic measures for the most effective management of this category of patients with peripheral nerve injury. Materials and methods: The research is based on the results of surgical treatment of 138 patients with combat injuries of peripheral nerves for the period from 2014 to 2020. The mean age was 33.5 ± 2.1 years. Patients were treated for 1 to 11 months after injury (median – 8 months). Damage to the sciatic nerve was observed in 26.1%, ulnar – in 20.3%, median – in 18.8%, radial – in 15.9%, tibial – in 10.9%, common peroneal nerve – in 8% of cases. Results: It was shown that in all patients was significantly improved the recovery of all nerves. In the period from 9 to 12 months, the degree of recovery of motor function to M0-M2 was observed in 40.6%, to M3 – in 35.5%, to M4 – in 16.7%, to M5 – in 7,2%. The degree of recovery of sensitivity to S0-S2 was observed in 36.2%, to S3 – in 42.8%, to S4 – in 17.4%, to S5 – in 3.6%. Regression of pain syndrome after surgery was observed in 81.2% of patients. Conclusions: The results of surgical treatment of peripheral nerves gunshot injury are generally worse than other types of nerve injuries. The best results of surgical treatment of combat trauma of peripheral nerves are obtained in patients with sciatic nerve damage.

Anatomical variations between the sciatic nerve and the piriformis muscle: a contribution to surgical anatomy in piriformis syndrome

2013 ◽  
Vol 36 (3) ◽  
pp. 273-280 ◽  
Author(s):  
Konstantinos Natsis ◽  
Trifon Totlis ◽  
George A. Konstantinidis ◽  
George Paraskevas ◽  
Maria Piagkou ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Anatomical Variations ◽  
Surgical Anatomy ◽  
Piriformis Syndrome ◽  
Piriformis Muscle

scholarly journals Piriformis Syndrome in Fibromyalgia: Clinical Diagnosis and Successful Treatment

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Md Abu Bakar Siddiq ◽  
Moshiur Rahman Khasru ◽  
Johannes J. Rasker
Keyword(s):  
Sciatic Nerve ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Piriformis Syndrome ◽  
Leg Length ◽  
Piriformis Muscle ◽  
Canal Stenosis ◽  
Gluteal Pain ◽  
Lumbar Spinal

Piriformis syndrome is an underdiagnosed extraspinal association of sciatica. Patients usually complain of deep seated gluteal pain. In severe cases the clinical features of piriformis syndrome are primarily due to spasm of the piriformis muscle and irritation of the underlying sciatic nerve but this mysterious clinical scenario is also described in lumbar spinal canal stenosis, leg length discrepancy, piriformis myofascial pain syndrome, following vaginal delivery, and anomalous piriformis muscle or sciatic nerve. In this paper, we describe piriformis and fibromyalgia syndrome in a 30-year-old young lady, an often missed diagnosis. We also focus on management of the piriformis syndrome.

scholarly journals Pyomyositis of the Piriformis Muscle—A Case of Piriformis Syndrome

2021 ◽  
Author(s):  
S Shanmuga Jayanthan ◽  
S. Senthil Rajkumar ◽  
V. Senthil Kumar ◽  
M. Shalini
Keyword(s):  
Sciatic Nerve ◽  
Rare Case ◽  
Muscle Hypertrophy ◽  
Anatomical Variations ◽  
Nerve Entrapment ◽  
Nerve Compression ◽  
Piriformis Syndrome ◽  
Piriformis Muscle

AbstractPiriformis syndrome is a rare cause of sciatica, which results in low backache due to sciatic nerve compression. This syndrome is associated with abnormalities in the piriformis muscle, which cause sciatic nerve entrapment, like anatomical variations, muscle hypertrophy, and inflammation. It can also result from the abnormal course of sciatic nerve itself through normal piriformis muscle. Piriformis syndrome due to pyomyositis of the piriformis muscle is extremely rare and only 23 cases are reported in literature. Herein, we report one such rare case of a patient, with pyomyositis of piriformis muscle, who presented with piriformis syndrome.

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