TARGETED ULTRASOUND-GUIDED PERINEURAL HYDRODISSECTION OF THE SCIATIC NERVE AND CORTICOSTEROID INJECTION FOR THE TREATMENT OFPIRIFORMIS SYNDROME

Abstract

Piriformis syndrome is a common cause of lumbar, gluteal, and thigh pain frequently associated with sciatic nerve symptoms. Etiology depends on individual predisposition or congenital anomalies. The mechanism is sciatic nerve impingement under the tendinous portion of the piriformis muscle due to spasm of the muscle. There is a common pathological end pathway involving hypertrophy, spasm, contracture, inammation, and scarring of the piriformis muscle, leading to impingement of the sciatic nerve. Ultrasound guided piriformis injection is frequently used in the treatment of piriformis syndrome, with most of the published literature describing injection of the muscle. We described a safe, effective ultrasound-guided injection technique for the treatment of piriformis syndrome among patients attending Physical Medicine & Rehabilitation (PMR) outpatient and inpatient departments in SSKM hospital, Kolkata (December 2019-June 2021) not responding to conservative management by using the targeted sciatic perineural hydrodissection followed by therapeutic corticosteroid injection.