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Identifying the level of entrapment is an important consideration for surgery as decompressing the wrong area will lead to a failed surgery (e.g. performing back surgery for extra-spinal sciatica), [2] [3] failure to treat nerve entrapment early can lead to permanent nerve injury, [4] and the patient may be unnecessarily exposed to surgical ...
The inferior gluteal nerve divides into three collateral branches: (i) the gluteus branch, (ii) the perineal branch, and (iii) the femoral branch. The first ramification—the gluteus branch—is a branch nerve that is very close to the emergence of the inferior gluteal nerve to the area, next to the inferior border of the pyramidalis muscle. [5]
Surgery is generally reserved for patients whose symptoms do not improve with nonsurgical treatments, and the main objective of surgery is to relieve pressure on the spinal nerve roots and recover normal mobility and quality of life. [10] Lower spinal decompression is considered the mainstay of surgical treatment. [2]
[21] [20] [78] Recently, advances in endoscopic surgery led to discoveries suggesting a broader classification was necessary to describe all the causes of sciatic nerve entrapment in the deep gluteal space. [79] This broader classification is now called deep gluteal syndrome, of which piriformis syndrome is one cause. [79] [29]
The sciatic nerve is highly mobile in the deep gluteal space with hip and even knee movements. [7] For example, hip flexion with knee extension (also called a straight leg raise) causes the sciatic nerve in the deep gluteal space to move 28mm towards the center of the body. [14] Hip movements may also create dynamic impingement between muscles.
The use of a nerve decompression or neurectomy to treat nerve pain along the lateral femoral cutaneous nerve is a firmly established surgical treatment. [ 24 ] [ 25 ] However, the more effective treatment between a decompression and neurectomy is still being researched.
[20] [21] There are now many known causes of sciatic nerve entrapment, such as fibrous bands restricting nerve mobility, that are unrelated to the piriformis in the deep gluteal space. Deep gluteal syndrome was created as an improved classification for the many distinct causes of sciatic nerve entrapment in this anatomic region. [21] Piriformis ...
Nerve compression syndrome, or compression neuropathy, or nerve entrapment syndrome, is a medical condition caused by chronic, direct pressure on a peripheral nerve. [1] It is known colloquially as a trapped nerve, though this may also refer to nerve root compression (by a herniated disc, for example).
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