Document Detail

The endoscopic treatment of sciatic nerve entrapment/deep gluteal syndrome.
MedLine Citation:
PMID:  21071168     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: The purpose of this study was to investigate the historical, clinical, and radiographic presentation of deep gluteal syndrome (DGS) patients, describe the endoscopic anatomy associated with DGS, and assess the effectiveness of endoscopic surgical decompression for DGS.
METHODS: Sciatic nerve entrapment was diagnosed in 35 patients (28 women and 7 men). Portals for inspection of the posterior peritrochanteric space (subgluteal space) of the hip were used as well as an auxiliary posterolateral portal. Patients were treated with sciatic nerve decompression by resection of fibrovascular scar bands, piriformis tendon release, obturator internus, or quadratus femoris or by hamstring tendon scarring. Postoperative outcomes were evaluated with the modified Harris Hip Score (MHHS), verbal analog scale (VAS) pain score, and a questionnaire related specifically to sciatic hip pain.
RESULTS: The mean patient age was 47 years (range, 20 to 66 years). The mean duration of symptoms was 3.7 years (range, 1 to 23 years). The mean preoperative VAS score was 6.9 ± 2.0, and the mean preoperative MHHS was 54.4 ± 13.1 (range, 25.3 to 79.2). Of the patients, 21 reported preoperative use of narcotics for pain; 2 continued to take narcotics postoperatively (unrelated to initial complaint). The mean time of follow-up was 12 months (range, 6 to 24 months). The mean postoperative MHHS increased to 78.0 and VAS score decreased to 2.4. Eighty-three percent of patients had no postoperative sciatic sit pain (inability to sit for >30 minutes).
CONCLUSIONS: Endoscopic decompression of the sciatic nerve appears useful in improving function and diminishing hip pain in sciatic nerve entrapment/DGS.
LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Hal D Martin; Shea A Shears; J Calvin Johnson; Aaron M Smathers; Ian J Palmer
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Publication Detail:
Type:  Journal Article     Date:  2010-11-11
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  27     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  172-81     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
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