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Sciatic Neurolysis And Piriformis Tendon Release: Case Series With A Minimum 2-Year Follow Up

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Sciatic Neurolysis And Piriformis Tendon Release: Case Series With A Minimum 2-Year Follow Up

Roger Quesada Jimenez, MD, UNITED STATES Elizabeth G. Walsh, BS, UNITED STATES Ady Haim Kahana Rojkind, MD, UNITED STATES Andrew R. Schab, BS, UNITED STATES Tyler R. McCarroll, MD, UNITED STATES Benjamin G. Domb, MD, UNITED STATES

American Hip Institute Research Foundation, Des Plaines, Illinois, UNITED STATES

2025 Congress ePoster Presentation 2025 Congress Not yet rated

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Nerve

Treatment / Technique

Endoscopy

Summary: Endoscopic release of the piriformis tendon and sciatic neurolysis have shown favorable outcomes for the diagnosis and treatment of piriformis syndrome.

Purpose

Piriformis syndrome (PS) is a rare but often underdiagnosed condition characterized by the entrapment of the sciatic nerve in the deep gluteal space, outside the spinal column. Modern endoscopic release of the piriformis tendon and exploration of the sciatic nerve is currently the gold standard of treatment for recalcitrant cases. This study aims to evaluate the outcomes of endoscopic sciatic neurolysis and piriformis release as treatment for PS with a minimum 2-year follow-up. A secondary aim is to present a comprehensive approach to enhance diagnostic accuracy.

Methods

Prospectively collected data was retrospectively analyzed for all patients who underwent endoscopic piriformis release and sciatic neurolysis as treatment for piriformis syndrome between 2010-2021. Included patients had completed pre-operative and minimum of 2-year postoperative questionnaires for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and Visual Analogue Scale (VAS) for pain and patient satisfaction. The MCID was calculated for the mentioned PROs and included in the analysis.

Results

A total of 18 patients were included in the study. All patients experienced symptom relief with a significant improvement in mHHS, NAHS, HOS-SSS, VAS and a high patient satisfaction rate. Furthermore, a high percentage of patients reached the calculated MCID for mHHS, NAHS, HOS-SSS, and VAS. Moreover, the presented algorithm optimizes the diagnosis of this pathology.

Conclusion

Establishing a comprehensive and organized protocol for the diagnosis and treatment of piriformis syndrome is essential. Endoscopic release of the piriformis tendon and sciatic neurolysis have shown favorable outcomes, high patient satisfaction rates, and a high percentage of patients reaching clinically important thresholds, with a low rate of complications at a minimum 2-year follow-up.

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Sciatic Neurolysis And Piriformis Tendon Release: Case Series With A Minimum 2-Year Follow Up

Sciatic Neurolysis And Piriformis Tendon Release: Case Series With A Minimum 2-Year Follow Up

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Sciatic Neurolysis And Piriformis Tendon Release: Case Series With A Minimum 2-Year Follow Up

Sciatic Neurolysis And Piriformis Tendon Release: Case Series With A Minimum 2-Year Follow Up

Purpose

Methods

Results

Conclusion