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KMID : 1040020220130020090
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International Journal of Pain
2022 Volume.13 No. 2 p.90 ~ p.98
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Sciatic Nerve Entrapment in Deep Gluteal Space (Piriformis syndrome) as a Cause of Failed Back Surgery Syndrome: A Case Report
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Son Byung-Chul
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Abstract
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Sciatica, characterized by low back pain and radiating leg pain, is most commonly caused by degenerative spinal lesions involving the lumbosacral nerve root. However, it can be caused by any disorders affecting the sciatic nerve pathway in the pelvic and hip regions. Piriformis syndrome, entrapment of the sciatic nerve at the greater sciatic foramen in the subgluteal region, is an underdiagnosed and non-discogenic cause of sciatica. In patients with chronic sciatica due to piriformis syndrome, the coexistence of degenerative lumbar lesions, which may be judged as the cause of pain on magnetic resonance imaging (MRI) of the lumbar spine, increases the risk of unnecessary back surgery. The risk of failed back surgery syndrome is higher if physicians are unaware of the symptom characteristics of piriformis syndrome, such as pain at rest and sitting intolerance. Here we report a case of a patient with failed back surgery syndrome due to piriformis syndrome who underwent lumbar spine surgery without a lesion that could clearly explain the pain on lumbar MRI. Symptoms of piriformis syndrome, diagnosed late after the two back surgeries, improved after sciatic nerve decompression.
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KEYWORD
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failed back surgery syndrome, pain, piriformis syndrome, sciatic nerve
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FullTexts / Linksout information
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Listed journal information
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