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Anatomic variations in nerve branching can also predispose the sciatic nerve to further compression by the piriformis muscle, such as if the sciatic nerve pierces the piriformis muscle. [ 35 ] The sciatic nerve can also be entrapped outside of the pelvic space and this is called deep gluteal syndrome . [ 19 ]
A sciatic nerve injury occurs between 0.5% and 2.0% of the time during a hip replacement. [7] Sciatic nerve palsy is a complication of total hip arthroplasty with an incidence of 0.2% to 2.8% of the time, or with an incidence of 1.7% to 7.6% following revision.
Nerve injury is an injury to a nerve.There is no single classification system that can describe all the many variations of nerve injuries. In 1941, Herbert Seddon introduced a classification of nerve injuries based on three main types of nerve fiber injury and whether there is continuity of the nerve. [1]
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Nerve gliding cannot proceed with injuries or inflammations as the nerve is trapped by the tissue surrounding the nerve near the joint. Thus, nerve gliding exercise is widely used in rehabilitation programs and during the post-surgical period. Radial, median, sciatic, and ulnar nerves require nerve gliding exercise during the rehabilitation period.
A heavily scrutinized anatomic variation involves sciatic nerve branching around the piriformis using the 6 category classification first described by Beaton and Anson. In this classification, the normal anatomy (type A) seen in about 80% of people is where the sciatic nerve passes under the piriformis muscle at the greater sciatic notch.
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 nerve roots from L4–S4 join in the sacral plexus which affects the sciatic nerve, which travels caudally (toward the feet). Compression, trauma or other damage to this region of the spinal canal can result in cauda equina syndrome. [citation needed] The symptoms may also appear as a temporary side-effect of a sacral extra-dural injection. [9]