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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.
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.
When the piriformis shortens or spasms due to trauma or overuse, it is posited that this causes compression of the sciatic nerve. [16] Piriformis syndrome has colloquially been referred to as "wallet sciatica" since a wallet carried in a rear hip pocket compresses the buttock muscles and sciatic nerve when the bearer sits down. Piriformis ...
Piriformis syndrome occurs when the piriformis irritates the sciatic nerve, which comes into the gluteal region beneath the muscle, causing pain in the buttocks and referred pain along the sciatic nerve. [8] This referred pain is known as sciatica. Seventeen percent of the population has their sciatic nerve coursing through the piriformis muscle.
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 inferior gluteal nerve leaves the pelvis through the greater sciatic foramen, passing inferior to the piriformis muscle. [5] It then divides into muscular branches to supply the gluteus maximus that pass posteriorly into the deep surface of the gluteus maximus muscle. [6] The inferior gluteal nerve is superficial to the sciatic nerve.
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