Infected Hematoma After Endoscopic Sciatic Nerve Decompression

Bloom, David A.; Essilfie, Anthony A.; Wolfert, Adam J.; Youm, Thomas

doi:10.1016/j.asmr.2019.11.002

Cited by 2 publications

(2 citation statements)

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“…Yoon et al described successful endoscopic resection of the tip of acetabular screw causing sciatic nerve irritation after revision total hip arthroplasty [ 10 ]. Postoperative recurrence due to the development of an infected hematoma after endoscopic sciatic neurolysis was reported in a 24-year-male that required open surgical evacuation and six weeks of postoperative antibiotics [ 8 ]. Our review analysis showed only one case of postoperative recurrence due to a foreign body reaction that was salvaged by open surgical decompression [ 25 ].…”

Section: Reviewmentioning

confidence: 99%

“…Though piriformis syndrome was considered synonymous with DGS in the past, it has now been recognized that piriformis syndrome is only a subgroup of DGS. Other potential causes include overuse-related conditions, high-energy trauma such as acetabular fractures or posterior hip dislocations and postoperative scarring, hematoma, protruding hardware, or heterotopic ossification [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Sciatic Neurolysis for Deep Gluteal Syndrome: A Systematic Review

Metikala¹,

Sharma²

2022

Cureus

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Deep gluteal syndrome (DGS) is an underdiagnosed condition caused by an extra-spinal entrapment of the sciatic nerve in the deep gluteal space. Symptomatic patients who fail conservative treatment require surgical decompression of the nerve either by an open or endoscopic approach. In recent times, there has been an increasing trend towards minimally invasive surgery performed with endoscopic techniques. This systematic review aimed to assess the effectiveness of endoscopic sciatic nerve decompression in the management of DGS. A comprehensive search of the PubMed, Web of Science, Cumulated Index to Nursing and Allied Health Literature (CINAHL), and SPORTDiscus databases were performed on January 3, 2022. All English-language clinical studies on DGS treated with endoscopic surgical decompression were included. The initial search criteria identified 145 articles, of which four studies were available for the final review. There was one level III evidence, while the remaining three were level IV, comprising 144 patients with a mean age of 46 years. The Coleman methodology score (CMS) was utilized to assess the quality of the studies and the mean score was 62 (range, 52 to 71). The presence of fibrovascular bands and bursal tissue was the most common cause of DGS, followed by musculotendinous structures. The average follow-up of the included studies was 26.3 months (range, 12 to 32 months). Less favorable outcomes were seen in patients with major traumatic sciatic neuropathies after fractures or open reconstructive hip surgeries. Conversion to formal open surgery was recorded in one case of DGS caused by sciatic nerve schwannoma due to poor endoscopic access. One patient developed postoperative recurrent sciatic nerve entrapment due to a foreign body reaction requiring an open decompression. Overall, the available studies reported a high degree of clinical success with a low rate of complications, albeit no high-quality studies could be identified.

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Section: Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%