tailieunhanh - Jawish et al. Journal of Orthopaedic Surgery and Research 2010, 5:3

Jawish et al. Journal of Orthopaedic Surgery and Research 2010, 5:3 RESEARCH ARTICLE Open Access Anatomical, Clinical and Electrical Observations in Piriformis Syndrome Roger M Jawish1,2*, Hani A Assoum2, Chaker F Khamis3 Abstract Background: We provided clinical and electrical descriptions of the piriformis syndrome, contributing to better understanding of the pathogenesis and further diagnostic criteria. Methods: Between 3550 patients complaining of sciatica, we concluded 26 cases of piriformis syndrome, 15 females, 11 males, mean age year-old. We operated 9 patients, 2 to 19 years after the onset of symptoms, 5 had piriformis steroids injection. A dorsolumbar MRI were performed in all cases and a. | Jawish et al. Journal of Orthopaedic Surgery and Research 2010 5 3 http content 5 1 3 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH RESEARCH ARTICLE Open Access Anatomical Clinical and Electrical Observations in Piriformis Syndrome Roger M Jawish1 2 Hani A Assoum2 Chaker F Khamis3 Abstract Background We provided clinical and electrical descriptions of the piriformis syndrome contributing to better understanding of the pathogenesis and further diagnostic criteria. Methods Between 3550 patients complaining of sciatica we concluded 26 cases of piriformis syndrome 15 females 11 males mean age year-old. We operated 9 patients 2 to 19 years after the onset of symptoms 5 had piriformis steroids injection. A dorsolumbar MRI were performed in all cases and a pelvic MRI in 7 patients. The electro-diagnostic test was performed in 13 cases between them the H reflex of the peroneal nerve was tested 7 times. Results After a followup 1 to 11 years for the 17 non operated patients 3 patients responded to conservative treatment. 6 of the operated had an excellent result 2 residual minor pain and one failed. 3 new anatomical observations were described with atypical compression of the sciatic nerve by the piriformis muscle. Conclusion While the H reflex test of the tibial nerve did not give common satisfaction in the literature for diagnosis the H reflex of the peroneal nerve should be given more importance because it demonstrated in our study more specific sign with six clinical criteria it contributed to improve the method of diagnosis. The cause of this particular syndrome does not only depend on the relation sciatic nerve-piriformis muscle but the environmental conditions should be considered with the series of the anatomical anomalies to explain the real cause of this pain. Background Since many years we had a particular interest for the intractable sciatica with failure of long term treatment of lumbar pain. In such cases our investigation was focused .

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