| Piriformis Syndrome versus Radiculopathy Following Lumbar Artificial Disc Replacement. | |
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MedLine Citation:
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PMID: 21270711 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ABSTRACT: Study Design: Case seriesObjective: To describe the presentation, diagnostic challenges, and treatment of five patients with piriformis syndrome following lumbar artificial disc replacement.Summary of Background Data: Until recently, spinal fusion was considered the standard for surgical treatment of severe lumbar degenerative disc disease. However, artificial disc replacement now offers an alternative solution. Piriformis syndrome results from entrapment of the sciatic nerve at the greater sciatic notch, with symptoms of pain and numbness radiating from the buttock to the foot, mimicking radiculopathy.Methods: In this case series, we report five patients who developed piriformis at our institution following artificial disc replacement.Results: Five patients, aged 35 to 46, developed some or all of the following symptoms in the affected leg after artificial disc replacement: posterior leg and buttock pain, calf weakness, and toe and ball of foot numbness and tingling. The onset of symptoms ranged from six days to eight months postoperative, and became debilitating over time. Each patient was diagnosed with piriformis syndrome through physical examination. Three of the patients received a piriformis injection and reported 50%-100% pain relief lasting one to three weeks. The patients subsequently underwent physical therapy that provided relief of their piriformis syndrome-related pain and enabled them to resume their normal activities.Conclusions: Piriformis syndrome has not previously been described in the literature as a sequela of lumbar artificial disc replacement. Our case series indicates that this complication may be under-diagnosed. Careful consideration following artificial disc replacement is required if the patient presents with buttock, leg or foot pain, and/or numbness. It is important for physicians to recognize the symptoms of piriformis syndrome and to differentiate piriformis syndrome from nerve root compression and irritation or referred pain from spinal structures. Although controversial, the proper diagnosis of piriformis syndrome may have prevented some of these patients from undergoing unnecessary surgical procedures. |
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Authors:
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Elizabeth S Robinson; Emily M Lindley; Peter Gonzalez; Susan Estes; Robert Cooley; Evalina L Burger; Vikas V Patel |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-1-25 |
Journal Detail:
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Title: Spine Volume: - ISSN: 1528-1159 ISO Abbreviation: - Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-1-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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The Spine Center, University of Colorado Denver, Colorado, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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