Management and results of sciatic nerve injuries: a 24-year experience

Kline, David G.; Kim, Daniel H.; Midha, Rajiv; Harsh, Carter; Tiel, Robert L.

doi:10.3171/jns.1998.89.1.0013

Cited by 207 publications

(201 citation statements)

References 27 publications

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“…Some of the largest published studies have been generated from data collected between 1968 to 1999 at Louisiana State University Hospital. 20,21,34 Other notable studies include those of Gousheh et al 13 and Aydin et al, 2 representing primarily military-related injuries of the sciatic nerve. These studies show variable rates of success, depending on the level of injury and whether the tibial or peroneal branches were involved.…”

Section: Discussionmentioning

confidence: 99%

Challenges in sciatic nerve repair: anatomical considerations

Burks¹,

Levi²,

Hayes³

et al. 2014

JNS

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Section: Discussionmentioning

confidence: 99%

Challenges in sciatic nerve repair: anatomical considerations

Burks¹,

Levi²,

Hayes³

et al. 2014

JNS

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“…After evaluation of the results, Millesi [16] also proposed simultaneous tendon transfer for patients with a significant nerve defects. According to their extensive experience with 380 sciatic nerve injuries, Kline et al [4] stated that when nerve grafting was required, functional outcomes were poor rate 71% recovery for the tibial nerve and 32% for the peroneal nerve. They also recommended that secondary tendon transfers reserved in poor peroneal division recovery after 3-5 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…A complete and severe loss of sciatic nerve function with no evidence of recovery during the first few months is generally accepted as indication for surgical repair. [4,20,23] The management of sciatic nerve injuries depends on loss of nerve continuity or lesion in continuity. If there is good vascularity and soft tissue coverage, sharp lacerations should be managed within a few days using the end-to-end technique.…”

Section: Discussionmentioning

confidence: 99%

“…Gunshot wounds, lacerations, penetrating trauma, femoral shaft fractures, contusion, compression, and iatrogenic injuries are the etiologic causes of many injuries at the thigh level. [3,4] Anatomically, the sciatic nerve is the longest and the largest diameter nerve of the body. It is composed of two different independent tibial and peroneal components.…”

Section: Sonuçmentioning

confidence: 99%

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The Functional Results of Acute Nerve Grafting in Traumatic Sciatic Nerve Injuries

Vayvada

Demirdöver²,

Menderes³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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“…Etiologies of sciatic neuropathy can include traumatic, compressive, ischemic, neoplastic, or idiopathic etiologies. Traumatic injuries can include injury to the sciatic nerve in association with femur fracture, hip dislocation or fracture, laceration, gunshot wound, or posterior thigh compartment syndrome [1,3,4,[24][25][26]. Compressive injuries can include compression from compartment syndrome, hematoma, hamstring injuries, fibrous bands, persistent sciatic artery, or controversially, from piriformis syndrome [6,7,[26][27][28][29][30][31][32][33][34][35].…”

Section: Etiologies Of Sciatic Neuropathymentioning

confidence: 99%

Sciatic Neuropathy: Case Report and Discussion of the Literature on Postoperative Sciatic Neuropathy and Sciatic Nerve Tumors

Feinberg

Sethi

2006

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Sciatic nerve injury and dysfunction is not an uncommon cause of lower extremity symptoms in a musculoskeletal practice. We present the case of a man who presented with lower extremity weakness, pain, and cramps, and was initially diagnosed at an outside institution with bilateral S1 radiculopathies and recommended for spine surgery. He came to us for a second opinion. Electrodiagnostic testing revealed an isolated sciatic neuropathy and the patient was referred for imaging, which showed a sciatic nerve sheath tumor. Review of the literature on sciatic neuropathies shows that there can be many possible etiologies of sciatic nerve dysfunction, but that hip arthroplasty continues to be the leading risk factor. Sciatic nerve tumors are not commonly described in the literature and their definitive management remains unclear.Key words Sciatic nerve . Lumbar radiculopathy . Electrodiagnostics . Electromyography . Nerve tumors Case discussionThe subject is a 52-year-old man with a 16-year history of mild, intermittent low back pain who presented with a chief complaint of pain, cramps, and weakness in the left lower extremity. He complained of a 2-month history of persistent pain in the upper thigh-lower buttock region with pain radiating to the left leg, calf, and toes. His pain ranged from 6 to 9 on a 10-point scale, with worse pain when lying down, flexing, walking uphill, and bending. Pain lessened with rest and short periods of stretching. He denied any specific complaint of back pain, numbness, and changes in bowel or bladder function. He denied any constitutional symptoms.The patient had his first episode of back pain 16 years earlier, at which time he responded to a treatment of acupuncture and stretching. He had occasional recurrent symptoms but did well until 4 years ago, when he began to experience pain predominantly down the right lower limb and sciatica. He underwent a course of physical therapy and trigger point injections and his symptoms resolved. He was then relatively well until the current episode.The patient underwent electrodiagnostic testing several weeks after the onset of his presenting symptoms. As per written reports presented by the patient, abnormal spontaneous activity was detected in isolation in the right and left gastrocnemius muscles. There was no involvement of any of the proximal muscles including the paraspinal muscles. The patient was diagnosed with bilateral S1 radiculopathies. A recent magnetic resonance imaging (MRI) showed mild disk bulges and disk degeneration most pronounced at the L4/5 level, without significant foraminal or canal compromise. This study, in comparison to a study performed 4 years earlier during the patient's prior episode of right-sided sciatic complaints, showed no significant changes.Except for this main complaint, the patient's medical history was significant only for hypertension and partial amputation of the left thumb secondary to trauma. The patient had no medication allergies and was taking p.r.n. narcotic pain medications, antihypertensive pa...

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Management and results of sciatic nerve injuries: a 24-year experience

Abstract: Surgical exploration and, when necessary, repair of sciatic nerve injuries is worthwhile in selected cases.

Cited by 207 publications

References 27 publications

Challenges in sciatic nerve repair: anatomical considerations

Challenges in sciatic nerve repair: anatomical considerations

The Functional Results of Acute Nerve Grafting in Traumatic Sciatic Nerve Injuries

Sciatic Neuropathy: Case Report and Discussion of the Literature on Postoperative Sciatic Neuropathy and Sciatic Nerve Tumors

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