Intrapelvic entrapment of sacral nerve roots by abnormal bundles of the piriformis muscle: description of an extra-spinal cause of sciatica and pudendal neuralgia.

Autor:	Sermer C; Mount Sinai Hospital, 700 University Avenue, Room 8-917, Toronto, ON M5S 1Z5, Canada., Li ALK; Mount Sinai Hospital, 700 University Avenue, Room 8-917, Toronto, ON M5S 1Z5, Canada., Fernandes GL; Department of Gynecology, Federal University of São Paulo. Rua Napoleão de Barros, 608, São Paulo, SP, Brazil.; Department of Gynecology, Faculdade de Ciências Médicas da Santa Casa de São Paulo. Rua Doutor Cesário Mota Júnior, 42, São Paulo, SP, Brazil., Ribeiro AM; Department of Gynecology, Federal University of São Paulo. Rua Napoleão de Barros, 608, São Paulo, SP, Brazil., Polesello G; Department of Gynecology, Faculdade de Ciências Médicas da Santa Casa de São Paulo. Rua Doutor Cesário Mota Júnior, 42, São Paulo, SP, Brazil., Tokechi D; Department of Radiology, Hospital Sírio-Libanês, Rua Dona Adma Jafet, 91, São Paulo, SP, Brazil., Cancelliere L; Mount Sinai Hospital, 700 University Avenue, Room 8-917, Toronto, ON M5S 1Z5, Canada., Lemos N; Mount Sinai Hospital, 700 University Avenue, Room 8-917, Toronto, ON M5S 1Z5, Canada.; Department of Gynecology, Federal University of São Paulo. Rua Napoleão de Barros, 608, São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of hip preservation surgery [J Hip Preserv Surg] 2021 May 19; Vol. 8 (1), pp. 132-138. Date of Electronic Publication: 2021 May 19 (Print Publication: 2021).
DOI:	10.1093/jhps/hnab041
Abstrakt:	Piriformis syndrome is a well-known extra-spinal cause of sciatica characterized by the entrapment of the sciatic nerve by variant bundles of the piriformis muscles in the deep gluteal space. In this case series, we describe the entrapment of intrapelvic portions of the sacral nerve roots by a variant bundle of the piriformis muscle originating medially to the sacral foramina, the surgical technique for the laparoscopic treatment of this condition, and the outcomes of the first eight cases treated with this technique. Five female and three male patients presenting with sciatica, pudendal pain and lower urinary tract symptoms underwent a laparoscopic exploration of the intrapelvic portion of the sacral nerve roots and transection of the abnormal piriformis bundle. Surgical technique is demonstrated in the Supplementary Video. Clinical success was achieved in seven of the eight patients, with a reduction of pain numeric rating scale from 8.5 (±1.2; 7-10) pre-operatively to 2.1 (±2.6; 0-7), 1-year following surgery. In conclusion, entrapment of intrapelvic portions of the sacral nerve roots by variant bundles of the piriformis originating medially to the sacral foramina are an extraspinal cause of sciatica, which can be treated though a laparoscopic approach. (© The Author(s) 2021. Published by Oxford University Press.)
Databáze:	MEDLINE
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