A minimally invasive surgical approach for the treatment of piriformis syndrome: a case series

Elizabeth Hogan; Darshan Vora; Jonathan H Sherman

doi:10.1186/s41016-020-00189-y

A minimally invasive surgical approach for the treatment of piriformis syndrome: a case series

Chin Neurosurg J. 2020 Mar 30:6:8. doi: 10.1186/s41016-020-00189-y. eCollection 2020.

Authors

Elizabeth Hogan¹, Darshan Vora², Jonathan H Sherman¹

Affiliations

¹ Department of Neurosurgery, the George Washington University, 2150 Pennsylvania Avenue, NWSuite 7-420, Washington, DC 20037 USA.
² Medicine and Health Sciences, the George Washington University, Washington, DC USA.

Abstract

Background: Piriformis syndrome accounts for approximately 6% of patients who present with sciatic pain. There are many treatment options ranging from physical therapy, to trigger point injections, to surgical intervention. We discuss a surgical method that represents a minimally invasive technique for the treatment of piriformis syndrome.

Methods: We describe a novel operative approach and technique for release of the piriformis muscle in the treatment of piriformis syndrome. Described are the preoperative planning, incision and approach, and technique for identifying and releasing the piriformis muscle.

Results: Three patients were treated for piriformis syndrome using the described technique. Each patient displayed successful relief of their symptoms immediately following the surgical procedure and at delayed follow-up.

Conclusion: Early experience with our method of piriformis release suggests that it is well suited for the treatment of piriformis syndrome. The novel integration of pre-operative trigger point localization coupled with intraoperative neuromonitoring allows effective pain relief with minimal morbidity.

Keywords: Minimally invasive; Neuromonitoring; Piriformis syndrome; Sciatic nerve.