Journal articles on the topic 'Sciatic nerve'
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Margiana, Ria, Kamila Alawiyah, Khoirul Ima, Rizni Fitriana, Arif Rahmat Widodo, and Theresa Devi Wibowo. "Improvement of Walking Analysis using the Sciatic Function Index for Sciatic Nerve Function in Injured Rat Model Treated with Low-Intensity Aerobics." Open Access Macedonian Journal of Medical Sciences 9, A (November 27, 2021): 1162–68. http://dx.doi.org/10.3889/oamjms.2021.7289.
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BACKGROUND: Sciatica is a disease of the peripheral nerves. Sciatica indicates that there is damage to the peripheral nerves in the sciatic nerves. Factors that can affect this disease include gender, posture, parity, age, genetic factors, and occupation. Some of the pathophysiological conditions of sciatica include the pathology of the intervertebral disc, dorsal root, and sciatic nerve itself. The results of standard therapy with surgery have not been effective and very expensive. Therefore, research on therapy in sciatica cases still needs to be done and evaluated. Physical exercise treatment (aerobic] is necessary for this therapy in sciatica cases due to promote the function of peripheral nerves. AIM: This study aimed to determine the effect of aerobic exercise treatment on peripheral nerve injury and its relationship to walking function during injury-induced peripheral nerve regeneration. METHODS: This study was an experimental study with a post-test. he study sample consisted of Male Sprague-Dawley rats with an age of about 2-3 months divided into three groups. Control group was conducted by surgery without clamping/injuring the peripheral nerves. The treatment for second group (P1) was clamping/injury of peripheral nerve and given the treatment of physical exercise with aerobics. The treatment for third group (P2) was clamping/injury of peripheral nerve and not given the treatment of physical exercise with aerobics. The intensity of giving physical exercise treatment with aerobic that is carried out is for 42 days. Nerve functional evaluation was carried out using the sciatic function index (SFI) method. Histological staining for sciatic was used hematoxylin-Eosin (HE) staining and immunohistochemistry with Growth Associated Protein 43 (GAP43) [Bioss, bs-0154R] and S100 antibody [ab52642]. This research was approved by Animal Ethics Committee of University of Indonesia protocol (No.19-07-0852). RESULTS: There was a significant change between the 7th and 14th days (p<0.001; paired t-test) in the P1 treatment. Improvement in nerve function was found on the 14th day after being given aerobic treatment. This is indicated by the data average change in SFI scores on days 7 and 4 was from -144 to 34. This data is also supported by footprint changes for injured hindfoot data. CONCLUSION: Low intensity aerobics treatment improve the walking function and nerve function in sciatic nerve injury on day 14. This is due to the effect of physical exercise on the injured sciatic nerve.
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Kale, Ahmet, Gulfem Basol, Ahmet C. Topcu, Elif C. Gundogdu, Taner Usta, and Recep Demirhan. "Intrapelvic Nerve Entrapment Syndrome Caused by a Variation of the Intrapelvic Piriformis Muscle and Abnormal Varicose Vessels: A Case Report." International Neurourology Journal 25, no. 2 (June 30, 2021): 177–80. http://dx.doi.org/10.5213/inj.2040232.116.
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Entrapment neuropathy of the sciatic nerve and pudendal nerve are painful syndromes that are often overlooked by physicians. Laparoscopic surgical interventions for nerve entrapment syndromes of the posterior pelvis focus on removing the compression lesion with the purpose of eliminating the suspected cause of sciatica, as well as pudendal neuralgia. Herein, the authors report the rare event of sciatic and pudendal nerve entrapment, which was caused by aberrant vessels and a variant piriformis muscle bundle, as a seldom-diagnosed cause of sciatica and pelvic pain, for both neurosurgeons and neuropelveologists. The authors present the laparoscopic decompression technique for the pudendal and sciatic nerves by giving our technical “tips and tricks” enriched by a surgical video.
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McCabe, Fergus J., and John P. McCabe. "An Unusual Presentation of Right-Sided Sciatica with Foot Drop." Case Reports in Orthopedics 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/9024368.
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Rarely, sciatica is of extraspinal aetiology. By compressing the sciatic nerve, swelling of the short external rotators of the hip can cause sciatica. Uncommon anatomical relationships between the sciatic nerve and local muscles may potentiate this compressive effect. In this report, we describe the presentation of right sciatica and foot drop resulting from both extreme local constriction and unusual anatomical variation of the right sciatic nerve.
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Kumar, Shalini, Priyanka Rana, and Shayama Kumari Razdan. "Variations in the gluteal region and its clinical significance – A cadaveric study." Indian Journal of Clinical Anatomy and Physiology 7, no. 4 (January 15, 2021): 346–49. http://dx.doi.org/10.18231/j.ijcap.2020.073.
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Anatomical structures involving muscles and nerves in the gluteal region are important as any variations of Sciatic nerve (SN) and its surrounding muscles like piriformis muscle (PM) can lead to entrapment or compression of this nerve causing sciatica and piriformis syndrome. To find out variations in the gluteal region related to piriformis muscle and the nerves surrounding it. The study was done on 20 embalmed cadavers (total 40 gluteal regions) during routine cadaveric dissection. The anatomical relations of the piriformis and surrounding nerves i.e. sciatic nerve, its divisions and gluteal nerves were studied. The dissection was done on 40 gluteal regions. In 36 gluteal regions (90%) the sciatic nerve emerged below the piriformis as a single trunk. While in 4 gluteal regions (10%) there was a higher division of sciatic nerve. In one cadaver we observed an accessory piriformis muscle just inferior to the main piriformis muscle. The sciatic nerve was also dividing higher up into common peroneal nerve and tibial nerve in the gluteal region. The common peroneal nerve (CPN) was observed emerging between the main and the accessory piriformis muscle. Along with it the inferior gluteal nerves were also seen traversing between the main and the accessory piriformis muscle.Knowledge of anatomical variations in the gluteal region is important to explain the myalgia and neuropathies in this region. This knowledge is also important in performing hip surgeries and giving intramuscular injections in the gluteal region.
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Bharadwaj, Upasana Upadhyay, Vanja Varenika, William Carson, Javier Villanueva-Meyer, Simon Ammanuel, Matthew Bucknor, Nathaniel M. Robbins, Vanja Douglas, and Cynthia T. Chin. "Variant Sciatic Nerve Anatomy in Relation to the Piriformis Muscle on Magnetic Resonance Neurography: A Potential Etiology for Extraspinal Sciatica." Tomography 9, no. 2 (February 22, 2023): 475–84. http://dx.doi.org/10.3390/tomography9020039.
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Objective: To assess the prevalence and clinical implications of variant sciatic nerve anatomy in relation to the piriformis muscle on magnetic resonance neurography (MRN), in patients with lumbosacral neuropathic symptoms. Materials and Methods: In this retrospective single-center study, 254 sciatic nerves, from 127 patients with clinical and imaging findings compatible with extra-spinal sciatica on MRN between 2003 and 2013, were evaluated for the presence and type of variant sciatic nerves, split sciatic nerve, abnormal T2-signal hyperintensity, asymmetric piriformis size and increased nerve caliber, and summarized using descriptive statistics. Two-tailed chi-square tests were performed to compare the anatomical variant type and clinical symptoms between imaging and clinical characteristics. Results: Sixty-four variant sciatic nerves were identified with an equal number of right and left variants. Bilateral variants were noted in 15 cases. Abnormal T2-signal hyperintensity was seen significantly more often in variant compared to conventional anatomy (40/64 vs. 82/190; p = 0.01). A sciatic nerve split was seen significantly more often in variant compared to conventional anatomy (56/64 vs. 20/190; p < 0.0001). Increased nerve caliber, abnormal T2-signal hyperintensity, and asymmetric piriformis size were significantly associated with the clinically symptomatic side compared to the asymptomatic side (98:2, 98:2, and 97:3, respectively; p < 0.0001 for all). Clinical symptoms were correlated with variant compared to conventional sciatic nerve anatomy (64% vs. 46%; p = 0.01). Conclusion: Variant sciatic nerve anatomy, in relation to the piriformis muscle, is frequently identified with MRN and is more likely to be associated with nerve signal changes and symptomatology.
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Deepthi, CNV. "VARIATIONS IN COURSE OF SCIATIC NERVE IN ADULT HUMAN CADAVERS." International Journal of Advanced Research 10, no. 10 (October 31, 2022): 1135–39. http://dx.doi.org/10.21474/ijar01/15589.
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Most of the sciatic nerve course in individuals is normal and variations in sciatic nerve is seen in approximately sixteen to twenty five percent of cases. Often sciatica is misdiagnosed. Pseudo-sciatica occurs as a result of non-spinal etiological factors. Understanding the origin and course of sciatic nerve is needed to correctly diagnose sciatica. The present study is undertaken to determine the normal course of sciatic nerve, along with its variations. Material And Methods: The following study was conducted on variation of sciatic nerve found during routine dissection of 100 cadavers for teaching purpose, in the Department of Anatomy, Govt. Medical College, Kurnool and other medical colleges in Kurnool. There were no other gross anomalies or pathologies. The skin around the area was normal and no evidence of surgery was present. The gluteal region was dissected and Gluteus maximus muscle was reflected and exposing the sciatic nerve and Piriformis muscle. Result: The incidence of variation in sciatic nerve is very low and is noted firstly in the right side of the cadaver. The occurrence of variation is 16 in 100 cadavers. Eighty four cadavers showed normal course of sciatic nerve. Out of sixteen cadavers, ten cadavers showed variation related to type b ranging 62.5% of total variations seen. Four cadavers showed type c variation ranging 25 % of total variations. Two cadavers were seen with a variation of type e ranging 12.5%. Conclusion: Sciatic nerve is the thickest, largest and longest nerve in the body. Its pathologies are also frequent in occurrence in daily life. A thorough knowledge of its anatomy and variations of sciatic nerve is required to give proper treatment plan to the patient. Also the, significance of it should not be overlooked during surgical and popliteal nerve block anaesthetic procedures.
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Siquara de Sousa, Ana C., Stepan Capek, Benjamin M. Howe, Mark E. Jentoft, Kimberly K. Amrami, and Robert J. Spinner. "Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases." Neurosurgical Focus 39, no. 3 (September 2015): E15. http://dx.doi.org/10.3171/2015.6.focus15208.
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Sciatic nerve endometriosis (EM) is a rare presentation of retroperitoneal EM. The authors present 2 cases of catamenial sciatica diagnosed as sciatic nerve EM. They propose that both cases can be explained by perineural spread of EM from the uterus to the sacral plexus along the pelvic autonomie nerves and then further distally to the sciatic nerve or proximally to the spinal nerves. This explanation is supported by MRI evidence in both cases. As a proof of concept, the authors retrieved and analyzed the original MRI studies of a case reported in the literature and found a similar pattern of spread. They believe that the imaging evidence of their institutional cases together with the outside case is a very compelling indication for perineural spread as a mechanism of EM of the nerve.
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Haspolat, Yavuz, Feyza Unlu Ozkan, Ismail Turkmen, Bahattin Kemah, Yalcin Turhan, Serhan Sarar, and Korhan Ozkan. "Sciatica due to Schwannoma at the Sciatic Notch." Case Reports in Orthopedics 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/510901.
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Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we aimed to present an unusual location of schwannoma along sciatic nerve that causes sciatica. A 60-years-old-man was admitted to us with complaints of pain on his thigh and paresthesia on his foot. Radiography of the patient revealed a solitary lesion on the sciatic nerve. The lesion was excised and the symptoms resolved after surgery.
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Atoni, Atoni D., Charles A. Oyinbo, Daminola A. U. Francis, and Ugochukwu L. Tabowei. "Anatomic Variation of the Sciatic Nerve: A Study on the Prevalence, and Bifurcation Loci in Relation to the Piriformis and Popliteal Fossa." Acta Medica Academica 51, no. 1 (June 9, 2022): 52. http://dx.doi.org/10.5644/ama2006-124.370.
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<p><strong>Objective</strong>. To examine and identify sciatic nerve variations in relation to the piriformis muscle, its prevalence, pattern and the course of its bifurcation loci.</p><p><strong>Materials and Methods</strong>. Twenty-eight formalin fixed male cadavers comprising 56 lower limbs were used for this study. Dissection of the gluteal region and posterior compartment of the thigh was conducted to expose the sciatic nerve. Variations in the sciatic nerve anatomy, their relationship to the piriformis muscle and points of bifurcation, and other observable features were noted and recorded.</p><p><strong>Results</strong>. Fifty-two lower limbs (93%) showed normal anatomy of the sciatic nerve. Four regions (7.1%) showed variations in the morphology of the sciatic nerve. Of these, one (1.8%) showed a variation of the sciatic nerve with the piriformis muscle. This single case showed a common peroneal nerve emerging on the left between the heads of a double piriformis muscle - a variant not described in the original Beaton and Anson classification, with the tibial nerve deep to the muscle. In two other limbs, the sciatic nerves showed a normal relationship with the piriformis, but had variations in the bifurcation loci (bilateral). The divisions were in upper third and middle third of the right and left thighs respectively.</p><p><strong>Conclusion</strong>. Knowledge of the level of bifurcation and distribution of the sciatic nerve and its location is important. This nerve is commonly encountered by neurologists, orthopaedics, and anaesthesiologists. The uncommon anatomical findings described are relevant to surgeons to enable them to perform efficient surgical procedures and avoid errors.</p><p>Sciatic Nerve; Bifurcation Loci; Piriformis; Sciatica</p>
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Lackermair, Stephan, Hannes Egermann, Franz Müller, Ingolf Töpel, Jozef Zustin, and Adolf Mülle. "Local compression of the sciatic nerve by a vascular malformation as a rare cause of sciatica: A case report and review of literature." Surgical Neurology International 15 (April 19, 2024): 139. http://dx.doi.org/10.25259/sni_132_2024.
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Background: Sciatica is typically caused by disc herniations or spinal stenosis. Extraspinal compression of the sciatic nerve is less frequent. Case Description: We report a rare case of sciatica with compression of the sciatic nerve by a low-flow vascular malformation in a 24-year-old female patient. The special feature of this case was sciatica along the S1 dermatome, which only occurred in the sitting position and inclination because of compression of the sciatic nerve between the vascular malformation and the lesser trochanter. Spinal imaging showed no abnormal findings. Surgery was performed interdisciplinary and included neurosurgery, vascular surgery, and trauma surgery. After surgery, the patient became symptom-free. Conclusion: Rare and extraspinal causes of local compression of the sciatic nerve should be considered, especially in cases of lacking spinal imaging correlation and untypical clinical presentation. Interdisciplinary surgical cooperation is of special value in cases of rare entities and uncommon locations.
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Cunha, Marco Túlio Rodrigues da, Alcino Lázaro da Silva, and Sheila Bernardino Fenelon. "Comparison of nerve graft integration after segmentar resection versus epineural burying in crushed rat sciatic nerves." Acta Cirurgica Brasileira 12, no. 4 (December 1997): 221–25. http://dx.doi.org/10.1590/s0102-86501997000400002.
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The aim of the present paper is to compare and correlate the take of nerve segments in a severely crushed nerve. Forty adult Wistar rats had their right sciatic nerve by a "Péan-Murphy" forceps for 40 minutes. In Group 1 (n=20), a segmentar serection in the crushed sciatic nerve was made. A sural nerve segment from the opposite hindpaw was placed in the gap. In Group 2 (n=20), a lontudinal insision in the epineurium of the lesioned sciatic nerve was made. A sural nerve segment was buried underneath the epineurium. The crushed sciatic nerves undergone Wallerian degeneration and endoneurial fibrosis. Sciatic nerves from Group 2 had significant better histological aspects than those from Group 1. Sural nerve grafts presented better degrees of regeneration than crushed sciatic nerves. Sural nerve grafts from Group 2 (burying method) integrated as well as those from Group 1 (segmentar resection).
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Jha, Ameet Kumar, and Prakash Baral. "Composite Anatomical Variations between the Sciatic Nerve and the Piriformis Muscle: A Nepalese Cadaveric Study." Case Reports in Neurological Medicine 2020 (March 31, 2020): 1–6. http://dx.doi.org/10.1155/2020/7165818.
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Piriformis syndrome is a rare syndrome which is one of the main causes of nondiscogenic sciatica causing severe low back pain due to entrapment of sciatic nerve either by the hypertrophy or by inflammation of the piriformis muscle. We have carried out dissection in 20 Nepalese cadavers. Out of 40 dissected gluteal regions, 37 exhibited typical appearance of sciatic nerve, piriformis muscle, and their relations resembling type-a, whereas 3 gluteal regions showed composite structural variations resembling type-b and type-c based on Beaton and Anson’s classification. Knowledge pertaining to such variations will be helpful during a surgical intervention in the gluteal region and in turn reduces the risk of injuring these nerves which are more susceptible to damage. Our study reports such variations in Nepalese population which will be helpful during evaluation of the pain induction in various test positions and also useful for analysis of the range of the neurological deficiency in sciatic nerve neuropathies. The present study also explains the basis of the unsuccessful attempt of the sciatic nerve block during popliteal block anaesthesia.
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Agarwal, Pawan, Dhananjaya Sharma, Sudesh Wankhede, P. C. Jain, and N. L. Agrawal. "Sciatic Nerve to Pudendal Nerve Transfer: Anatomical Feasibility for a New Proposed Technique." Indian Journal of Plastic Surgery 52, no. 02 (May 2019): 222–25. http://dx.doi.org/10.1055/s-0039-1688513.
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Abstract Aim Restoration of bladder and bowel continence after pudendal nerve anastomosis has been shown successfully in animal models and may be applicable in humans. Aim of this cadaveric study was to assess feasibility of pudendal nerve neurotization using motor fascicles from sciatic nerve. Methods Pudendal and sciatic nerves were exposed via gluteal approach in 5 human cadavers (10 sites). Size of pudendal and sciatic nerves and the distance between two nerves was measured. Results There were four male and one female cadavers. Mean age was 62 (range, 50–70) years. Mean pudendal nerve diameter was 2.94 mm (right side) and 2.82 mm (left side). Mean sciatic nerve diameter was 11.2 mm (right side) and 14.2 mm (left side). The distance between two nerves was 23.4 mm on both sides. Conclusion Transfer of the motor fascicles from sciatic nerve to pudendal nerve to restore the bladder and bowel continence is feasible.
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Dinesh K, Patel, and Shinde Amol A. "Variations in Course and Branching of Sciatic Nerve and it’s Relation to Pyriformis Syndrome." International Journal of Anatomy and Research 9, no. 4 (December 5, 2021): 8156–59. http://dx.doi.org/10.16965/ijar.2021.173.
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Background: Sciatic nerve is a branch of sacral plexus. It passes below the pyriformis and divides in the popliteal fossa. Higher division and relation of sciatic nerve to pyriformis have been documented. Beaton and Anson have classified relation of sciatic nerve to pyriformis. The aim of this study is to find incidence of variant anatomy of sciatic nerve as per Beaton and Anson classification. Materials and methods: 48 formalin embalmed lower limbs used for regular anatomy teaching were used. Branching and course of sciatic nerve was observed in gluteal region,thigh and popliteal fossa. Observations: As per Beaton and Anson classification, we found 81.2% showed type A or normal arrangement. Type B variation was seen in 14.6% while 4.2% showed type D variation. Conclusion: Variations in branching of sciatic nerve and it’s relation to pyriformis muscle are important from point of view of Surgeons and Anaesthetists. Knowledge of these variations will help reducing block failures in cases of sciatica, pyriformis syndrome and hip replacement surgeries. KEY WORDS: Sciatic nerve, Sacral plexus, Pyriformis Syndrome, Hip replacement.
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Utomo, Sri Andreani, Abdul Hafid Bajamal, Muhammad Faris, Djohan Ardiansyah, and Johanes Hadi Lunardhi. "Long Completely Cystic Sciatic Schwannoma: A Rare Case." Case Reports in Oncology 14, no. 1 (March 22, 2021): 561–67. http://dx.doi.org/10.1159/000514633.
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Schwannomas are the most common peripheral nerve sheath tumors. Benign schwannomas with malignant transformation are rarely reported. Most common schwannomas occur in the head and neck region. Sciatic schwannomas are rare, as are completely cystic schwannomas. Sciatic nerve schwannomas represent less than 1% of all schwannomas. Benign tumors in the sciatic nerve consist of 60% neurofibromas and 38% schwannomas. In general, a schwannoma induces chronic symptoms. It can be misleading, sometimes mimicking degenerative spinal pathology due to disc herniation. Schwannoma involving the sciatic nerve can be asymptomatic or may present with sciatica or neurological deficits. Most schwannomas are solid or heterogeneous tumors, and completely cystic schwannomas are rare. The differential diagnoses of nondiscogenic sciatica include lumbar disc herniation, tumor, abscess, hematoma, facet syndrome, lumbar instability, sacroiliitis, piriformis syndrome, and sciatic neuritis. We report a rare case of a long completely cystic sciatic schwannoma in the left foraminal L5–S1 zone extending to the left ischial groove with chronic sciatica that was diagnosed radiologically with a combination of conventional MRI and MR neurography and confirmed histopathologically by surgical resection. The patient previously had conservative therapy, but the complaints were not reduced. Nonsurgical therapy is considered the first choice, and surgical therapy is indicated in cases that do not respond to conservative therapy, with recurrent cysts, severe pain, or neurological deficits.
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Robinson, Lawrence R., and Linda Probyn. "How Much Sciatic Nerve Does Hip Flexion Require?" Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, no. 2 (January 30, 2019): 248–50. http://dx.doi.org/10.1017/cjn.2018.378.
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ABSTRACT:Measured nerve conduction velocity in the fibular nerve increases across the knee during hip flexion. This is due to stretching of sciatic and fibular nerves. We modeled the additional nerve length required for the sciatic nerve to course around the flexed hip, based upon distance between the hip and the sciatic nerve on magnetic resonance imaging (MRI). The median distance from the femoral head to the sciatic nerve was 41 mm. The model predicted that 64 mm of sciatic nerve is required for hip flexion. This impacts our understanding of lower limb nerve conduction studies and clinical straight leg raising tests.
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Munakomi, Sunil, and Pratyush Shrestha. "Case Report: Sciatic nerve schwannoma - a rare cause of sciatica." F1000Research 6 (March 14, 2017): 267. http://dx.doi.org/10.12688/f1000research.11108.1.
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Herein we report a rare case of a sciatic nerve schwannoma causing sciatica in a 69-year-old female. Sciatic nerve schwannoma is a rare entity. It should always be considered as a possible cause of sciatica in patients that present with symptoms of sciatica with no prolapsed disc in the lumbar spine and a negative crossed straight leg raise test. Timely diagnosis and complete excision of the lesion leads to complete resolution of the symptoms of such patients.
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Benzon, Honorio T., Charles Kim, Hazel P. Benzon, Mark E. Silverstein, Barbara Jericho, Katherine Prillaman, and Ricardo Buenaventura. "Correlation between Evoked Motor Response of the Sciatic Nerve and Sensory Blockade." Anesthesiology 87, no. 3 (September 1, 1997): 547–52. http://dx.doi.org/10.1097/00000542-199709000-00014.
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Background Incomplete sensory blockade of the foot after sciatic nerve block in the popliteal fossa may be related to the motor response that was elicited when the block was performed. We investigated the appropriate motor response when a nerve stimulator is used in sciatic nerve block at the popliteal fossa. Methods Six volunteers classified as American Society of Anesthesiologists' physical status I underwent 24 sciatic nerve blocks. Each volunteer had four sciatic nerve blocks. During each block, the needle was placed to evoke one of the following motor responses of the foot: eversion, inversion, plantar flexion, or dorsiflexion. Forty milliliters 1.5% lidocaine was injected after the motor response was elicited at < 1 mA intensity. Sensory blockade of the areas of the foot innervated by the posterior tibial, deep peroneal, superficial peroneal, and sural nerves was checked in a blinded manner. Motor blockade was graded on a three-point scale. The width of the sciatic nerve and the orientation of the tibial and common peroneal nerves were also examined in 10 cadavers. Results A significantly greater number of posterior tibial, deep peroneal, superficial peroneal, and sural nerves were blocked when inversion or dorsiflexion was seen before injection than after eversion or plantar flexion (P < 0.05). Motor blockade of the foot was significantly greater after inversion. Anatomically, the tibial and common peroneal nerves may be separate from each other throughout their course. The sciatic nerve ranged from 0.9-1.5 cm in width and was divided into the tibial and common peroneal nerves at 8 +/- 3 (range, 4-13) cm above the popliteal crease. Conclusions Inversion is the motor response that best predicts complete sensory blockade of the foot. Incomplete blockade of the sciatic nerve may be a result of the size of the sciatic nerve, to separate fascial coverings of the tibial and common peroneal nerves, or to blockade of either the tibial or common peroneal nerves after branching from the sciatic nerve.
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Deopujari, Rashmi, Dibya Kishore Satpathi, and Ashutosh S. Mangalgiri. "Clinical importance of anatomical variants of sciatic nerve in relation to the piriformis muscle." National Journal of Clinical Anatomy 01, no. 04 (October 2012): 160–64. http://dx.doi.org/10.1055/s-0039-3401685.
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Abstract Background and aims : The sciatic nerve usually emerges below the Piriformis muscle. Each anatomical variant of sciatic nerve is associated with a specific clinical presentation. The aim of the study was to identify the variants of sciatic nerve and to discuss their clinical importance. Materials and methods : Twenty one embalmed cadavers of known age and sex were used for this study. Gluteal regions of both sides were dissected to expose sciatic nerve. Variation of sciatic nerve in relation to piriformis was observed. Results and Conclusion: Out of the 42 dissected specimens - Five showed variations in sciatic nerve. Three specimens (two on right and one on left side) displayed common peroneal branch passing through piriformis. Three specimens (two on right and one on left side) showed tibial nerve emerging below piriformis.ln one specimen on left side common peroneal nerve emerged as two parts in relation to piriformis - one passing through piriformis and another below piriformis. A very unusual variant in which the tibial and common peroneal components of sciatic nerve were sandwiched between the three heads of piriformis muscle is also reported here in one case of right side. These variants are usually misdiagnosed in most of the cases due to similarity of clinical symptoms with low back ache and sciatica. Therefore the possibility of each such variant should be kept in mind by the clinicians.
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B. Belsare, Minal, Vidya Wasnik (Thatere), and Sumeeta S. Jain. "AYURVEDIC MANAGEMENT OF SCIATICA (GHRIDHRASI) W.S.R. TO LUMBAR DISC HERNIATION - A SINGLE CASE STUDY." International Ayurvedic Medical Journal 11, no. 6 (June 21, 2023): 1472–75. http://dx.doi.org/10.46607/iamj4311062023.
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Sciatica is a result of the sciatic nerve root pathology. It causes pain and paresthesia in the sciatic nerve distribution area. The most common cause of sciatica is a herniated or bulging lumbar intervertebral disc. Unresolved sciatic nerve compression causes increased pain over time, paresthesia and loss of muscular strength in the affected leg, loss of bowel and bladder function, permanent nerve damage. In Ayurveda it is correlated with Ghridhrasi. Case Report - A 73 yr male having complaints of Low back pain radiating to right lower limb, difficulty and pain while walking and sitting, tingling and numbness in right leg. Aim - To evaluate the effect of Ayurvedic treatment such as Yog Basti, Panchtikta-Ksheerbasti and Shaman Chikitsa for relieving the signs and symptoms of Lumbar disc herniation co-related to Ghridhrasi. Result - Patient got marked relief in SLRT, Femoral Stretch Test, Braggard’s Sign Test, The Roland-Morris low back pain and disability questionnaire. Conclusion-The mentioned Ayurvedic therapy gives symptomatic relief for the management of Sciatica (Gridhrasi).
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Floyd, John R., Elizabeth R. Keeler, Elizabeth D. Euscher, and Ian E. McCutcheon. "Cyclic sciatica from extrapelvic endometriosis affecting the sciatic nerve." Journal of Neurosurgery: Spine 14, no. 2 (February 2011): 281–89. http://dx.doi.org/10.3171/2010.10.spine09162.
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Sciatic (catamenial) radiculopathy, waxing and waning with the menstrual cycle, is an uncommon condition typically caused by pelvic endometriosis affecting the lumbosacral plexus or proximal sciatic nerve. The authors describe a woman with catamenial sciatica caused by endometriosis affecting the sciatic nerve trunk in the upper thigh. Symptomatic with leg pain for 5 years, this patient developed gluteal atrophy and sensory loss and decreased strength in the L-5 dermatomyotome, a distribution confirmed by electromyography. Magnetic resonance imaging suggested thickening of the sciatic nerve at and distal to the sciatic notch. At operation the nerve showed extrinsic and intrinsic abnormality, proven to be endometriosis. Her symptoms improved, and she began gonadotropin-releasing hormone agonist therapy for further suppression. This very unusual case shows that endometriosis can affect the sciatic nerve over a range of territory inside and outside the pelvis, and that surgery must be appropriately directed to avoid negative exploration. Surgical decompression achieves good relief of symptoms, and medical therapy also allows sustained suppression of this disease.
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Hamdi, MF, I. Aloui, and Kh Ennouri. "Sciatica secondary to sciatic nerve schwannoma." Neurology India 57, no. 5 (2009): 685. http://dx.doi.org/10.4103/0028-3886.57786.
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Singh, Kunwar Pal, Prabhjot Singh, and Kamlesh Gupta. "Reference values for the cross-sectional area of the normal sciatic nerve using high-resolution ultrasonography." Journal of Ultrasonography 21, no. 85 (2021): e95-e104. http://dx.doi.org/10.15557/jou.2021.0018.
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Aim: High-resolution ultrasonography is a new and promising technique to evaluate peripheral and spinal nerves. Its validity as a diagnostic tool in neurological diseases has been demonstrated in adults. The aims of study were to establish the reference values for the cross-sectional area of the normal sciatic nerve on high-resolution ultrasonography, and to determine the relationship between the cross-sectional area of the normal sciatic nerve and the subjects’ age, gender, height (in cm), weight (in kg), and body mass index. Material and methods: Two hundred subjects of both genders and above 18 years of age were studied with high-resolution ultrasonography. The subjects had no history of peripheral neuropathy or trauma to the lower limb. The cross-sectional areas of the normal sciatic nerves were obtained at two different levels in both lower limbs. The mean cross-sectional areas of the sciatic nerves were measured at two different levels, one located at 1 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves, and the other 4 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves. Results: A positive correlation of the mean cross-sectional area was established with height, weight, and body mass index. Women had smaller cross-sectional areas of the normal sciatic nerves than men at both measuring sites. No significant relationship was established with the age of the subjects. Conclusions: The established reference values of the cross-sectional area of the sciatic nerve can facilitate the analysis of pathological nerve conditions.
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Bunc, Gorazd, Janez Ravnik, and Matjaž Voršič. "Pelvic expansion hidden by concomitant lumbar compression as a cause of sciatica - report of three cases." Acta Medico-Biotechnica 3, no. 1 (November 21, 2021): 45–50. http://dx.doi.org/10.18690/actabiomed.32.
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Purpose: Three patients with sciatica caused by contemporary involvement of intra- and extraspinal compression of the sciatic nerve are presented.
Case report: The diagnostic workup initially revealed intraspinal compression as the cause of sciatica. All patients underwent surgery that did not lead to clinical improvement. Additional diagnosis in two patients and autopsy in one revealed that residual pain was caused by nerve sheath tumors in two cases and pelvic abscess compression of the lumbosacral plexus in the third case.
Conclusion: Extraspinal compression of the sciatic nerve should be considered where standard surgical decompression of the intraspinal cause of sciatica fails to improve the clinical picture.
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Pandit, Tinku Kumari, Shanta Hada, and Muna Kadel. "VARIATIONS OF SCIATIC NERVE BIFURCATION: A CADAVERIC STUDY." Journal of Chitwan Medical College 12, no. 4 (December 31, 2022): 39–42. http://dx.doi.org/10.54530/jcmc.1160.
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Background: The sciatic nerve is formed in the pelvic cavity and leaves the cavity through the greater sciatic foramen below the piriformis muscle. It terminates by giving tibial and common peroneal (fibular) nerve near the superior angle of the popliteal fossa. Awareness of variations in bifurcation of sciatic nerve is significant during deep intramuscular gluteal injections, clinical conditions such as piriformis syndrome, sciatica, coccygodynia and muscle atrophy. The main objective of this study was to highlight the site of bifurcation of sciatic nerve. Methods: An observational cross–sectional study was performed in the Department of Anatomy of KIST medical college & Teaching Hospital, Lalitpur, Nepal. The data was collected after ethical approval from Institutional Review Committee. 50 specimens were taken in the study by convenient sampling method. Sciatic nerve was observed in respect to its site of bifurcation. Results: Out of 50 lower limbs, in 30 specimens (60%) the sciatic nerve showed bifurcation near the superior angle of popliteal fossa. 20 lower limbs (40%) showed variations,of which eight limbs (16%) showed division of nerve prior to its exit in the gluteal region, eight limb (16%) showed division in upper 2/3rd of back of thigh and four limbs (8%) showed division of the nerve in the popliteal fossa. Conclusions: This study concludes that the majority of sciatic nerve divides at the superior angle of the popliteal fossa while some divided into other regions such as pelvis, thigh & popliteal fossa.
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Stenberg, Lena, Derya Burcu Hazer Rosberg, Sho Kohyama, Seigo Suganuma, and Lars B. Dahlin. "Injury-Induced HSP27 Expression in Peripheral Nervous Tissue Is Not Associated with Any Alteration in Axonal Outgrowth after Immediate or Delayed Nerve Repair." International Journal of Molecular Sciences 22, no. 16 (August 11, 2021): 8624. http://dx.doi.org/10.3390/ijms22168624.
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We investigated injury-induced heat shock protein 27 (HSP27) expression and its association to axonal outgrowth after injury and different nerve repair models in healthy Wistar and diabetic Goto-Kakizaki rats. By immunohistochemistry, expression of HSP27 in sciatic nerves and DRG and axonal outgrowth (neurofilaments) in sciatic nerves were analyzed after no, immediate, and delayed (7-day delay) nerve repairs (7- or 14-day follow-up). An increased HSP27 expression in nerves and in DRG at the uninjured side was associated with diabetes. HSP27 expression in nerves and in DRG increased substantially after the nerve injuries, being higher at the site where axons and Schwann cells interacted. Regression analysis indicated a positive influence of immediate nerve repair compared to an unrepaired injury, but a shortly delayed nerve repair had no impact on axonal outgrowth. Diabetes was associated with a decreased axonal outgrowth. The increased expression of HSP27 in sciatic nerve and DRG did not influence axonal outgrowth. Injured sciatic nerves should appropriately be repaired in healthy and diabetic rats, but a short delay does not influence axonal outgrowth. HSP27 expression in sciatic nerve or DRG, despite an increase after nerve injury with or without a repair, is not associated with any alteration in axonal outgrowth.
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Jandial, Sonia. "Unilateral higher division of sciatic nerve and its clinical importance." International Journal of Research in Medical Sciences 8, no. 1 (December 25, 2019): 355. http://dx.doi.org/10.18203/2320-6012.ijrms20195573.
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The sciatic nerve has a long course right from the pelvis to the apex of the popliteal fossa. The point of division of the sciatic nerve into tibial and common peroneal nerves is very variable. The variation in the division of the sciatic nerve described in the present study should be helpful for anaesthetists and orthopaedic surgeons. While doing the dissection and teaching of the gluteal region in the Post Graduate Department of Anatomy, government medical college, Jammu, it was found that on the left side tibial nerve and common peroneal nerve were present instead of sciatic nerve. It meant that the main nerve that is the sciatic nerve had already been divided into its terminal branches in the pelvis region. Both tibial and common peroneal nerve were seen coming out of the pelvis below the piriformis muscle, while on the right side there were no variation. The sciatic nerve was seen coming out of the pelvis below the piriformis muscle as usual. Because of this high division of the sciatic nerve in the pelvis, there are many complications like failed sciatic nerve block during anaesthesia while performing surgery, but high division of the sciatic nerve may result in escape of either tibial nerve or common peroneal nerve. The gluteal region, back of the thigh and leg of the lower limb were dissected to study further course of tibial nerve and the common peroneal nerve. Photographs were also taken.
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Bucknor, Matthew D., Lynne S. Steinbach, David Saloner, and Cynthia T. Chin. "Magnetic resonance neurography evaluation of chronic extraspinal sciatica after remote proximal hamstring injury: a preliminary retrospective analysis." Journal of Neurosurgery 121, no. 2 (August 2014): 408–14. http://dx.doi.org/10.3171/2014.4.jns13940.
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Object Extraspinal sciatica can present unique challenges in clinical diagnosis and management. In this study, the authors evaluated qualitative and quantitative patterns of sciatica-related pathology at the ischial tuberosity on MR neurography (MRN) studies performed for chronic extraspinal sciatica. Methods Lumbosacral MRN studies obtained in 14 patients at the University of California, San Francisco between 2007 and 2011 were retrospectively reviewed. The patients had been referred by neurosurgeons or neurologists for chronic unilateral sciatica (≥ 3 months), and the MRN reports described asymmetrical increased T2 signal within the sciatic nerve at the level of the ischial tuberosity. MRN studies were also performed prospectively in 6 healthy volunteers. Sciatic nerve T2 signal intensity (SI) and cross-sectional area at the ischial tuberosity were calculated and compared between the 2 sides in all 20 subjects. The same measurements were also performed at the sciatic notch as an internal reference. Adjacent musculoskeletal pathology was compared between the 2 sides in all subjects. Results Seven of the 9 patients for whom detailed histories were available had a specific history of injury or trauma near the proximal hamstring preceding the onset of sciatica. Eight of the 14 patients also demonstrated soft-tissue abnormalities adjacent to the proximal hamstring origin. The remaining 6 had normal muscles, tendons, and marrow in the region of the ischial tuberosity. There was a significant difference in sciatic nerve SI and size between the symptomatic and asymptomatic sides at the level of the ischial tuberosity, with a mean adjusted SI of 1.38 compared with 1.00 (p < 0.001) and a mean cross-sectional nerve area of 0.66 versus 0.54 cm2 (p = 0.002). The control group demonstrated symmetrical adjusted SI and sciatic nerve size. Conclusions This study suggests that chronic sciatic neuropathy can be seen at the ischial tuberosity in the setting of prior proximal hamstring tendon injury or adjacent soft-tissue abnormalities. Because hamstring tendon injury as a cause of chronic sciatica remains a diagnosis of exclusion, this distinct category of patients has not been described in the radiographic literature and merits special attention from clinicians and radiologists in the management of extraspinal sciatica. Magnetic resonance neurography is useful for evaluating chronic sciatic neuropathy both qualitatively and quantitatively, particularly in patients for whom electromyography and traditional MRI studies are unrevealing.
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Papadopoulos, Stephen M., John E. McGillicuddy, and Louis M. Messina. "Pseudoaneurysm of the Inferior Gluteal Artery Presenting as Sciatic Nerve Compression." Neurosurgery 24, no. 6 (June 1, 1989): 926–28. http://dx.doi.org/10.1227/00006123-198906000-00025.
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ABSTRACT A pseudoaneurysm of the inferior gluteal artery presenting as sciatic nerve compression is reported in a 40-year-old woman. Following a transvaginal needle biopsy for endometriosis, the patient developed left sciatic pain and a nonpulsatile mass palpable in the left buttock thought to represent a pyriformis hematoma. Sequential computed tomographic scans were consistent with this diagnosis. Persistent pain and progression of neurological deficits led to surgical exploration. Posterior exposure of the pyriformis muscle and proximal sciatic nerve revealed a large pseudoaneurysm of the inferior gluteal artery compressing the nerve. A laparotomy was performed and the internal iliac artery was ligated, followed by evacuation of the aneurysm contents and repair of the aneurysm neck via a posterior approach. The patient has remained pain-free with progressive improvement in neurological function after 1 year follow-up. Aneurysms of the gluteal artery are unusual, predominantly occur after significant pelvic trauma, and rarely present as sciatica. Pertinent aspects of the patient history and clinical findings are atypical for discogenic sciatica. Because of the rarity of this entity, preoperative diagnosis is usually not achieved. Angiography or magnetic resonance imaging should be performed in patients with atypical sciatica and a mass in the region of the proximal sciatic nerve, particularly after trauma.
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Shanmuga Jayanthan, S., S. Senthil Rajkumar, V. Senthil Kumar, and M. Shalini. "Pyomyositis of the Piriformis Muscle—A Case of Piriformis Syndrome." Indian Journal of Radiology and Imaging 31, no. 04 (October 2021): 1023–26. http://dx.doi.org/10.1055/s-0041-1739183.
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AbstractPiriformis syndrome is a rare cause of sciatica, which results in low backache due to sciatic nerve compression. This syndrome is associated with abnormalities in the piriformis muscle, which cause sciatic nerve entrapment, like anatomical variations, muscle hypertrophy, and inflammation. It can also result from the abnormal course of sciatic nerve itself through normal piriformis muscle. Piriformis syndrome due to pyomyositis of the piriformis muscle is extremely rare and only 23 cases are reported in literature. Herein, we report one such rare case of a patient, with pyomyositis of piriformis muscle, who presented with piriformis syndrome.
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RAYAN, G. M., S. I. SAID, S. L. CAHILL, and J. DUKE. "Vasoactive Intestinal Peptide and Nerve Regeneration." Journal of Hand Surgery 16, no. 5 (October 1991): 515–18. http://dx.doi.org/10.1016/0266-7681(91)90106-x.
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The role of vasoactive intestinal peptide (V.I.P.) in nerve regeneration was investigated by assessing the changes in immunoreactive V.I.P. levels in rat sciatic nerves following injury and repair. 60 rats were divided into three surgical groups and one control group: In group I (primary repair), sciatic nerves were divided and immediately repaired; in group II (secondary repair), sciatic nerves were divided and repaired two weeks later; in group III (no repair), sciatic nerves were divided and not repaired; and in group IV (controls), sciatic nerves were exposed but not divided. Animals were sacrificed at three days and at weekly intervals. Their sciatic nerves were extracted and assayed for V.I.P. concentrations by a specific radioimmunoassay. The mean V.I.P. concentration varied between 22 and 46 pg./mg. protein in the control nerves and between 60 and 529 pg./mg. protein in all other groups. In the three surgical groups the levels were significantly higher in proximal than in distal stumps. Following nerve injury, there was an increase in V.I.P. concentration in the injured and repaired areas. This increase was greater in injured non-repaired areas and was highest in the first 48 hours, but continued during regeneration. The accumulation of V.I.P. in divided nerves occurred in response to nerve injury.
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Piacherski, Valery G., and Lidiya V. Muzyka. "Comparison of the effectiveness of ultrasound-guided and ultrasound-guided subgluteal nerve blocks with peripheral nerve electrical stimulation: A randomized controlled feasibility trial." Regional Anesthesia and Acute Pain Management 16, no. 1 (July 20, 2022): 71–77. http://dx.doi.org/10.17816/1993-6508-2022-16-1-71-77.
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AIM: The efficacy of sciatic nerve blockade with subchondral access under ultrasound guidance (USG) versus ultrasound guidance in combination with EPN (USEPN) is unknown. Data on studies of these techniques for blockade of other peripheral nerves are inconsistent. This study evaluated the feasibility of a randomized trial to compare the efficacy of sciatic nerve blockade with USG-guided sciatic access with the current practice of USEPN.
MATERIALS AND METHODS: Forty patients were randomized into two groups in which USG or USEPN guidance was used to perform sciatic nerve blockade with sciatic access. The primary endpoint was the quality of the sensory block. The secondary endpoint was the quality of the motor block.
RESULTS: Two groups of 20 patients each were analyzed. All patients developed successful motor and sensory blocks of the sciatic nerve when using USG and USEPN. All cases were followed. Three patients were excluded before randomization because of the unsatisfactory ultrasound imaging of the sciatic nerve.
CONCLUSION: The results show that a prospective study of alternative techniques of sciatic nerve block by subchondral access is possible. In our pilot study, sciatic nerve block performed under USG guidance without EPN was effective in all cases.
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Trasolini, Nicholas A., Morgan Rice, Katlynn Paul, and Shane J. Nho. "Endoscopic Sciatic Neurolysis for Deep Gluteal Space Syndrome." Video Journal of Sports Medicine 2, no. 2 (March 2022): 263502542110632. http://dx.doi.org/10.1177/26350254211063213.
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Background: Deep gluteal syndrome (DGS) encompasses a spectrum of pathologies causing symptomatic sciatic nerve compression deep to the gluteus maximus muscle. Endoscopic sciatic neurolysis is an option for management of DGS when conservative treatment fails. Indications: Endoscopic sciatic neurolysis is indicated for retro-trochanteric pain, sciatica-like burning in the posterior thigh, and sitting discomfort that is reproducible on physical examination after failing conservative management. Technical Description: The technique presented here introduces a standard endoscopic sciatic neurolysis technique with an accessory posterolateral portal placed distally and in line with the sciatic nerve. Use of a switching stick through an accessory distal posterolateral portal can allow for in-line protection and retraction of the sciatic nerve while it is carefully released from compressive fibrous bands using an arthroscopic shaver. It is important that the accessory portal be placed under direct visualization with caution not to injure the sciatic nerve. An arthroscopic radiofrequency device can be used for hemostasis and further release of fibrous bands. At the end of the procedure, the sciatic nerve should be visualized fully released and freely mobile from the piriformis muscle to the level of the lesser trochanter. Results: In properly selected patients, the procedure is very successful. In a series of 35 cases, the procedure reduced sitting pain (present in 97% of patients preoperative, 17% of patients postoperative), reduced narcotic use, improved visual analog scale (VAS) pain scores, and improved modified Harris hip scores without major complications. Discussion: Although rare following hip arthroscopy, postoperative scarring and fibrous bands are a common cause of DGS which can be effectively treated by endoscopic sciatic nerve decompression. Results of endoscopic sciatic neurolysis have thus far been encouraging with improvements in patient reported outcome scores and high rates of satisfaction. However, complications do occur and can result in neurologic deficits. Nevertheless, with careful patient selection and meticulous sciatic nerve dissection, endoscopic sciatic neurolysis for DGS is a safe and effective technique for decompression of fibrous bands and adhesions that can lead to sciatic neuralgia.
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Carrasco, Ana López, Alicia Hernández Gutiérrez, Paula Alegría Hidalgo Gutiérrez, Roberto Rodríguez González, Patricia Isabel Salas Bolívar, Ramón Usandizaga Elio, Ignacio Zapardiel Gutiérrez, and Javier De Santiago García. "Sciatic Nerve Involvement as an Unusual Presentation of Deep Endometriosis." Journal of Endometriosis and Pelvic Pain Disorders 9, no. 2 (January 2017): 120–24. http://dx.doi.org/10.5301/jeppd.5000282.
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Introduction Endometriosis affecting the sciatic nerve is extremely uncommon. Its main symptom is catamenial sciatica but it can result in neuropathy. The diagnosis is usually delayed for years. Our objective is to communicate our experience in the diagnosis, management and treatment of this pathology by presenting two patients. Methods Retrospective revision of medical charts of all sciatic endometriosis cases treated in the Endometriosis Unit of the University Hospital, La Paz, Spain. Results Two nulliparous patients 35 and 39 years old, with unilateral sciatica related to sciatic nerve endometriosis are presented. The lag time between the onset of symptoms and diagnosis was 8 and 5 years. Both patients had problems with locomotion and muscle atrophy, so laparoscopic neurolysis was performed with success in pain control but not total recovery of deambulation defect. Conclusions Directed anamnesis and magnetic resonance imaging (MRI) are good tools for diagnosis of endometriosis affecting sciatic nerve. In absence of neuropathy, hormonal pharmacotherapy can be used to control symptoms, but when it is present, surgical nerve decompression must not be delayed, and laparoscopic approach is feasible for trained surgeons. In our cases, neurolysis improved pain but complete recovery of motor function has not been reached. Physicians responsible for primary care need to be aware of the catamenial sciatica due to the nerve damage caused by endometriosis, even when it is very uncommon, because the consequences of the delay in assessment and treatment by a specialized multidisciplinary team in dedicated units may be irreversible.
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Tschan, Christoph A., Doerthe Keiner, Harald D. Müller, Kerstin Schwabe, Michael R. Gaab, Joachim K. Krauss, Clemens Sommer, and Joachim Oertel. "Waterjet Dissection of Peripheral Nerves: An Experimental Study of the Sciatic Nerve of Rats." Operative Neurosurgery 67, suppl_2 (December 1, 2010): ons368—ons376. http://dx.doi.org/10.1227/neu.0b013e3181f9b0c8.
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ABSTRACT BACKGROUND: Although waterjet dissection has been well evaluated in intracranial pathologies, little is known of its qualities in peripheral nerve surgery. Theoretically, the precise dissection qualities could support the separation of nerves from adjacent tissues and improve the preservation of nerve integrity in peripheral nerve surgery. OBJECTIVE: To evaluate the potential of the new waterjet dissector in peripheral nerve surgery. METHODS: Waterjet dissection with pressures of 20 to 80 bar was applied on the sciatic nerves of 101 rats. The effect of waterjet dissection on the sciatic nerve was evaluated by clinical tests, neurophysiological examinations, and histopathological studies up to 12 weeks after surgery. RESULTS: With waterjet pressures up to 30 bar, the sciatic nerve was preserved in its integrity in all cases. Functional damaging was observed at pressures of 40 bar and higher. However, all but 1 rat in the 80 bar subgroup showed complete functional regeneration at 12 weeks after surgery. Histopathologically, small water bubbles were observed around the nerves. At 40 bar and higher, the sciatic nerves showed signs of direct nerve injury. However, all these animals showed nerve regeneration after 12 weeks, as demonstrated by histological studies. CONCLUSION: Sciatic nerves were preserved functionally and morphologically at pressures up to 30 bar. Between 40 and 80 bar, reliable functional and morphological nerve regeneration occurred. Waterjet pressures up to 30 bar might be applied safely under clinical conditions. This technique might be well suited to separate intact peripheral nerves from adjacent tumor or scar tissue. Further studies will have to show the clinical relevance of these dissection qualities.
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Sharma, U., S. Lama Moktan, and S. B. Shrestha. "Ultrasonographic Assessment of the Distance of Sciatic Nerve Bifurcation from the Popliteal Crease and its Depth from Skin in Volunteers." Kathmandu University Medical Journal 18, no. 2 (December 6, 2020): 73–77. http://dx.doi.org/10.3126/kumj.v18i2.33259.
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Background Sciatic nerve block used for various surgeries below knee and for maintenance of analgesia demonstrates wide variability regarding its bifurcation into tibial and common peroneal nerves, frequently accounting for incomplete nerve blocks.
Objective To determine the variation of sciatic nerve bifurcation among Nepalese volunteers.
Method This cross sectional study was conducted in the Department of Anesthesiology of Kathmandu Medical College Teaching Hospital from March to May 2019, where 110 healthy volunteers underwent ultrasonography of sciatic nerve starting from popliteal fossa to its bifurcation. The distance between the bifurcation of sciatic nerve from popliteal crease and depth of the nerve at that point from the skin were measured.
Result The mean distance at which sciatic nerve bifurcated from the popliteal crease was 5.42 ± 1.37 cm. Most commonly, the sciatic nerve bifurcated at a distance of 5-7 cm from the popliteal crease in 110 limbs (50.45%). However, in 80 limbs (36.69%), the bifurcation was found at less than 5 cm from the popliteal crease. The depth of the nerve from the skin at the point of bifurcation was 1.72 ± 0.54 cm, with results showing it was deeper in females compared to males (p value < 0.001).
Conclusion This study showed that though the distance of sciatic nerve bifurcation from the popliteal crease in our study group was coherent with the published literature of 5-12 cm; many volunteers also had this bifurcation at distances less than 5 cm. Females showed nerves to be deeper at the point of bifurcation than males.
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Van Gompel, Jamie J., Christoph J. Griessenauer, Bernd W. Scheithauer, Kimberly K. Amrami, and Robert J. Spinner. "Vascular Malformations, Rare Causes of Sciatic Neuropathy: A Case Series." Neurosurgery 67, no. 4 (October 1, 2010): 1133–42. http://dx.doi.org/10.1227/neu.0b013e3181ecc84e.
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Abstract BACKGROUND: Sciatica is typically a clear-cut symptom complex commonly related to an impingement at the spinal nerve level. Etiologies of sciatic neuropathy outside the neural foramina are uncommon. OBJECTIVE: To describe 4 patients presenting with radiating leg pain due to sciatic nerve involvement, all with a vascular etiology. METHODS: Four patients presenting with neuropathic pain were retrospectively reviewed. Preoperative 3 Tesla magnetic resonance imaging was used to identify these lesions, which most commonly showed diffuse T2 changes with nerve enhancement upon administration of contrast. RESULTS: Exploration revealed vascular lesions. All patients went on to external and limited internal neurolysis of the involved sciatic nerve segment. Intraoperative histological study confirmed the presence of a venous angioma, an arteriovenous malformation, a venous malformation associated with Klippel-Trenaunay syndrome, and a capillary hemangioma. Follow-up demonstrated stable neurological examinations with reduction in pain at 1 year or greater. CONCLUSION: In patients with sciatic distribution symptoms and signs, after initial negative spine imaging, high-resolution imaging of the sciatic nerve itself should be undertaken to address rarer causes such as vascular abnormalities. In these cases, exploration and fascicular biopsy provided a diagnosis; external and limited internal neurolysis improved pain.
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Chen, Huihao, Depeng Meng, Zheng Xie, Gang Yin, Chunlin Hou, and Haodong Lin. "Transfer of Sciatic Nerve Motor Branches in High Femoral Nerve Injury: A Cadaver Feasibility Study and Clinical Case Report." Operative Neurosurgery 19, no. 3 (May 27, 2020): E244—E250. http://dx.doi.org/10.1093/ons/opaa131.
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Abstract BACKGROUND Femoral nerve injury causes knee dysfunction, and high femoral nerve injury is difficult to repair. OBJECTIVE To evaluate the anatomic feasibility of transferring the sciatic nerve motor branches in high femoral nerve injury. METHODS The femoral nerve was exposed in both lower extremities of 3 adult fresh-frozen cadavers; each branch was noninvasively dissected to its proximal nerve fiber intersection point and distal muscle entry point. The branches of the sciatic nerve were also exposed. The length, diameter, and number of myelinated fibers were measured in each femoral and sciatic nerve branch. The feasibility of tension-free direct suture between the femoral and sciatic nerve branches was evaluated. One patient was treated with transfer of a nerve branch innervating the semitendinosus muscle to the femoral nerve branch and was followed up for 18 mo. RESULTS The diameters and numbers of myelinated fibers in the femoral nerve branches matched those of the sciatic nerve branches. In the single patient, a combined femoral nerve bundle (comprising the rectus femoris and vastus lateralis branches) was used as a graft. The branch of the sciatic nerve was sutured with the muscle branch of the femoral by using a sural nerve as a nerve graft. The knee joint straightening strength reached medical research council grade 4+. CONCLUSION The proximal motor branches of the sciatic nerve may be transferred as donor nerves to repair high femoral nerve injury. A femoral nerve bundle comprising the rectus femoris and vastus lateralis branches may be used as the receptor nerve.
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Park, Hyun-Jun, Myung-Hoon Shin, Jong-Tae Kim, and Du-Yong Choi. "A Rare Cause of Sciatica: Sciatic Nerve Schwannoma - A Case Report." Nerve 7, no. 1 (April 30, 2021): 11–15. http://dx.doi.org/10.21129/nerve.2021.7.1.11.
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Inoue, Motohiro, Tatsuya Hojo, Miwa Nakajima, Hiroshi Kitakoji, Megumi Itoi, and Yasukazu Katsumi. "The Effect of Electrical Stimulation of the Pudendal Nerve on Sciatic Nerve Blood Flow in Animals." Acupuncture in Medicine 26, no. 3 (September 2008): 145–48. http://dx.doi.org/10.1136/aim.26.3.145.
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Objective To investigate the mechanism of the clinical effect of electroacupuncture of the pudendal nerve on the lumbar and lower limb symptoms caused by lumbar spinal canal stenosis, we studied changes in sciatic nerve blood flow during electrical stimulation of the pudendal nerve in the rat. Methods Using rats (n=5), efferent electrical stimulation to the pudendal nerve was performed and sciatic nerve blood flow was measured with laser Doppler flowmetry. Simultaneously, changes in the blood pressure and cardiac rate were measured. Furthermore, the effect of atropine on these responses to the stimulation was also studied. Results Electrical stimulation of the pudendal nerve significantly increased blood flow in the sciatic nerve transiently without increasing heart rate and systemic blood pressure. The significant increase in the sciatic nerve blood flow disappeared after administration of atropine. Conclusion Electrical stimulation of the pudendal nerve causes a transient and significant increase in sciatic nerve blood flow. This response is eliminated or attenuated by administration of atropine, indicating that it occurs mainly via cholinergic nerves.
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JABBAR, ABDUL, ANJUM NAQVI, and MUMTAZ HAIDER. "SCIATIC NERVE." Professional Medical Journal 14, no. 02 (September 6, 2007): 328–36. http://dx.doi.org/10.29309/tpmj/2007.14.02.4899.
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Objective: To determine the number, size, somatotopy and segmental distribution of HRP labeledmotor and sensory neurons forming sciatic nerve in albino rat by using HRP technique. To fined out the distribution ofneurons in sciatic nerve in albino rat in spinal cord from L3S1. The average number, size and segmental distribution ofmotor and sensory neurons were localized by HRP method of tracing neuronal connections. The motor neurons formingSCN ranged 10-60 microns and extended between the caudal part of L3 and rostral part of SI spinal segment. Theyoccupied PPL, PL, C and aL subgroups. The peak frequency distribution of motor neurons was observed in L4-L6spinal segment in SCN. The labeled sensory neurons whose peripheral process run in SCN were localized in L3-S1ipsilateral Dorsal Root Ganglia (DRG). No somatotopic organization of the cells was found in the DRG. The cells weredistributed throughout the ganglia without forming groups. The somal diameters of sensory neurons forming SCNmeasured between 14-58 microns.
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Szeinfeld, Marcos, Krishnaprasad Deepika, C. Romero Lurie, John Klose, and Albert Varon. "SCIATIC NERVE." Anesthesiology 65, Supplement 3A (September 1986): A212. http://dx.doi.org/10.1097/00000542-198609001-00211.
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Khan, Gulam Anwer, Ajeevan Gautam, Shuvechha Shakya, and Amit Shrestha. "STUDY OF A VARIATION OF LUMBOSACRAL PLEXUS: SCIATIC NERVE AND ITS CLINICAL SIGNIFICANCE." Journal of Chitwan Medical College 12, no. 4 (December 31, 2022): 51–54. http://dx.doi.org/10.54530/jcmc.1130.
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Background: The pelvis is a home to pelvic parts of the sympathetic and parasympathetic nervous systems, the sacral and coccygeal plexuses, and the lumbosacral trunk. The lower spine’s sciatic nerve is made up of a combination of motor and sensory fibers from spinal nerves fourth lumbar to third sacral segment (ventral rami). The objective of study was to determine morphological variations in origin and formation of branching pattern of sciatic nerve. Methods: A descriptive cross-sectional study was conducted on twenty-four (forty-eight lower limbs) cadavers available in the Department of Anatomy at School of Basic Sciences, Chitwan Medical College. All damaged cadavers were excluded. The cadavers for undergraduate first year medical students dissected as per Cunningham’s Manual. The branching pattern of the sciatic nerve was noted. All Variation of each sacral plexus was photographed. Statistical analysis was done using Microsoft Excel and SPSS version 20. Both gluteal regions were studied for the locations and variation of the sciatic nerve. Results: Forty-eight lower limbs were examined. Among them forty-two lower limbs (87.5 percent) showed a normal anatomy of the sciatic nerve. Six lower limbs (12.5 percent) showed variations in the sciatic nerve. Conclusions: The study concluded that there are variations in origin and formation of branches of sciatic nerve. Variations of sciatic nerve observed could be beneficial for various surgical interventions like nerve release and pain management in compressed nerve.
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Bonner, S. M., and A. K. Pridie. "Sciatic nerve palsy following uneventful sciatic nerve block." Anaesthesia 52, no. 12 (December 1997): 1205–7. http://dx.doi.org/10.1111/j.1365-2044.1997.258-az0396.x.
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Cohnen, Jennifer, Lisa Kornstädt, Lisa Hahnefeld, Nerea Ferreiros, Sandra Pierre, Ulrike Koehl, Thomas Deller, Gerd Geisslinger, and Klaus Scholich. "Tumors Provoke Inflammation and Perineural Microlesions at Adjacent Peripheral Nerves." Cells 9, no. 2 (January 29, 2020): 320. http://dx.doi.org/10.3390/cells9020320.
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Cancer-induced pain occurs frequently in patients when tumors or their metastases grow in the proximity of nerves. Although this cancer-induced pain states poses an important therapeutical problem, the underlying pathomechanisms are not understood. Here, we implanted adenocarcinoma, fibrosarcoma and melanoma tumor cells in proximity of the sciatic nerve. All three tumor types caused mechanical hypersensitivity, thermal hyposensitivity and neuronal damage. Surprisingly the onset of the hypersensitivity was independent of physical contact of the nerve with the tumors and did not depend on infiltration of cancer cells in the sciatic nerve. However, macrophages and dendritic cells appeared on the outside of the sciatic nerves with the onset of the hypersensitivity. At the same time point downregulation of perineural tight junction proteins was observed, which was later followed by the appearance of microlesions. Fitting to the changes in the epi-/perineurium, a dramatic decrease of triglycerides and acylcarnitines in the sciatic nerves as well as an altered localization and appearance of epineural adipocytes was seen. In summary, the data show an inflammation at the sciatic nerves as well as an increased perineural and epineural permeability. Thus, interventions aiming to suppress inflammatory processes at the sciatic nerve or preserving peri- and epineural integrity may present new approaches for the treatment of tumor-induced pain.
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Raj Sharma, Amit, Anju Partap, and Kavita Negi. "THE BILATERAL HIGH DIVISION OF THE SCIATIC NERVE IN THE PELVIS." International Journal of Advanced Research 11, no. 05 (May 31, 2023): 91–94. http://dx.doi.org/10.21474/ijar01/16853.
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The sciatic nerve is the thickest nerve of the body.1 It leaves the pelvis below the piriformis via the greater sciatic foramen and descends between the ischial tuberosity and greater trochanter in the back of the thigh, dividing into the tibial and common peroneal nerves proximal to the knee however, the level of bifurcation can be variable.2The levels of division of the sciatic nerve are important in anaesthesia, orthopaedics, rehabilitation, and neurology.3The study was done by dissection of forty-two human adult lower limb specimens, irrespective of sex from the Department of Anatomy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. During dissection, 02(4.8%) specimens out of 42 specimens showed high division, 28(66.6%) specimens showed intermediate, and 12 (28.6%) specimens showed low division of the sciatic nerve.The bilateral highdivision of the sciatic nerve is a rare variation. Knowledge about the level of division of the sciatic nerve is important for clinicians and surgeons.
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Jian Huang, Eiji Shibata, Kanefusa Kato, Nobuyuki Asaeda, and Yasuhiro Takeuchi. "Chronic Exposure to n-Hexane Induces Changes in Nerve-Specific Marker Proteins in the Distal Peripheral Nerve of the Rat." Human & Experimental Toxicology 11, no. 5 (September 1992): 323–27. http://dx.doi.org/10.1177/096032719201100504.
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1 After long-term n-hexane exposure (2000 ppm, 12 h d-1, 6 d week-1, for 24 weeks), the content of neuron-specific enolase (gamma-enolase), creatine kinase-B and beta-S100 protein in the cortex, cerebellum, spinal cord and proximal and distal sciatic nerves of rats was determined by enzyme immunoassay. 2 The amounts of the three proteins decreased significantly in the distal segment of sciatic nerve, whereas they remained unchanged in the brain and proximal sciatic nerve. The quantitative decline in these marker proteins in the distal sciatic nerve could be related to neurophysiological deficits in the peripheral nerves. 3 This study indicates that the biochemical changes observed are consistent with the clinical and pathological findings of n-hexane neuropathy. These nerve-specific marker proteins can be used to assess solvent-related peripheral neurotoxicity.
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Kumari, K. Lakshmi, M. Sushma, A. Raja, and D. Asha Latha. "Anatomical study on sciatic nerve variations in Andhra Pradesh, India." International Journal of Research in Medical Sciences 7, no. 8 (July 25, 2019): 3085. http://dx.doi.org/10.18203/2320-6012.ijrms20193399.
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Background: The sciatic nerve is the largest and widest nerve in the body and is derived from ventral rami of spinal nerves L2 to S3. Sciatic nerve appears in the Gluteal region below Piriformis from Pelvic cavity by passing through Greater Sciatic foramen. In between the Ischial tuberosity and greater trochanter of Femur, it reaches the back of the thigh. At the superior angle of Popliteal fossa, it divides into Tibial and common Peroneal (fibular) nerves. The division varies, and it may occur within the pelvis, Gluteal, upper, mid and lower part of thigh. The anatomical variations of the level at which the Sciatic nerve divides is considered important by Neurosurgeons, Anaesthetists, Orthopaedicians and Surgeons.Methods: This study was conducted on 52 lower limbs to determine the level of sciatic nerve bifurcation and its variations on 26 embalmed human cadavers. The data was analyzed manually using numbers, frequencies and percentages.Results: The findings of this study states that in 2 limbs (3.84%) the nerve divided in the gluteal region; in 4 limbs (7.69%) in the pelvic region; in 10 limbs (19.23%) at the junction between upper and middle thigh. The highest incidence of division occurs in 36 limbs (69.23%) at the superior angle of the popliteal fossa.Conclusions: The findings of this study revealed that the majority of sciatic nerve divisions occur at the superior angle of popliteal fossa while some divided into other regions such as Pelvis, Gluteal and thigh regions.
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Benzon, Honorio T., Jeffrey A. Katz, Hubert A. Benzon, and Muhammad S. Iqbal. "Piriformis Syndrome." Anesthesiology 98, no. 6 (June 1, 2003): 1442–48. http://dx.doi.org/10.1097/00000542-200306000-00022.
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Background Piriformis syndrome can be caused by anatomic abnormalities. The treatments of piriformis syndrome include the injection of steroid into the piriformis muscle and near the area of the sciatic nerve. These techniques use either fluoroscopy and muscle electromyography to identify the piriformis muscle or a nerve stimulator to stimulate the sciatic nerve. Methods The authors performed a cadaver study and noted anatomic variations of the piriformis muscle and sciatic nerve. To standardize their technique of injection, they also noted the distance from the lower border of the sacroiliac joint (SIJ) to the sciatic nerve. They retrospectively reviewed the charts of 19 patients who had received piriformis muscle injections, noting the site of needle insertion in terms of the distance from the lower border of the SIJ and the depth of needle insertion at which the motor response of the foot was elicited. The authors tabulated the response of the patients to the injection, any associated diagnoses, and previous treatments that these patients had before the injection. Finally, they reviewed the literature on piriformis syndrome, a rare cause of buttock pain and sciatica. Results In the cadavers, the distance from the lower border of the SIJ to the sciatic nerve was 2.9 +/- 0.6 (1.8-3.7) cm laterally and 0.7 +/- 0.7 (0.0-2.5) cm caudally. In 65 specimens, the sciatic nerve passed anterior and inferior to the piriformis. In one specimen, the muscle was bipartite and the two components of the sciatic nerve were separate, with the tibial nerve passing below the piriformis and the peroneal nerve passing between the two components of the muscle. In the patients who received the injections, the site of needle insertion was 1.5 +/- 0.8 (0.4-3.0) cm lateral and 1.2 +/- 0.6 (0.5-2.0) cm caudal to the lower border of the SIJ as seen on fluoroscopy. The needle was inserted at a depth of 9.2 +/- 1.5 (7.5-13.0) cm to stimulate the sciatic nerve. Patients had comorbid etiologies including herniated disc, failed back surgery syndrome, spinal stenosis, facet syndrome, SIJ dysfunction, and complex regional pain syndrome. Sixteen of the 19 patients responded to the injection, their improvements ranged from a few hours to 3 months. Conclusions Anatomic abnormalities causing piriformis syndrome are rare. The technique used in the current study was successful in injecting the medications near the area of the sciatic nerve and into the piriformis muscle.
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Rugambwa, J. P., J. Umuhire, D. Nkusi, O. Kubwimana, and J. Gashegu. "Duplicated gluteus maximus muscle: rare variant anatomy: a case report - a case report." Rwanda Medical Journal 81, no. 1 (April 13, 2024): 167–70. http://dx.doi.org/10.4314/rmj.v81i1.20.
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The gluteal region is an important anatomical and clinical area that contains muscles and vital neurovascular bundles. The gluteus maximus is the largest and most powerful muscle in the human body. While there can be some anatomical variations in the gluteus maximus, they are generally minor and do not significantly affect its function; however, its proximity to the sciatic nerve necessitates attention. Hence, a thorough understanding of the gluteal region's anatomy is crucial. In the gluteal region of an adult male cadaver dissection for the postgraduate surgical trainees' regular cadaver dissection course, we discovered a variation of the gluteus maximus muscle that was duplicated with a superficial big portion and a deep small muscle component. The little portion was attached to the hip bone by two tendinous slips connected by a tendinous arch under which the sciatic nerve runs. With this type of anatomical disposition, the sciatic nerve may become entrapped if a small portion of the gluteus muscle hypertrophies, resulting in sciatica. Since the gluteus maximus can entrap the sciatic nerve, understanding the anatomy of the gluteal region is crucial for both anatomical and clinical reasons. Clinicians should be aware of this anatomy for successful surgeries of the gluteal region, intramuscular injections, and dealing with complaints of sciatica. Additional investigation and dissections of the gluteal region are urged for a better comprehension of human anatomy and its variability.