Piriformis syndrome resulting from a rare anatomic variation

Area of Science:

• Anatomy
• Neurology
• Surgical Case Report

Background:

• Piriformis syndrome can be associated with anatomical variations of the sciatic nerve and piriformis muscle.
• Beaton's classification describes six types of such anatomical variations.
• Surgical treatment for piriformis syndrome with Beaton type d variation is exceptionally rare in English literature.

Observation:

• A patient presented with sciatica, with lumbar MRI showing no nerve root compression.
• Pelvic MRI, sciatic nerve perineurography, and CT imaging suggested piriformis syndrome with anatomical variation.
• Surgical exploration confirmed Beaton type d anatomical variation of the piriformis muscle.

Findings:

• Resection of both anterior and posterior lobes of the piriformis muscle was performed.
• The patient experienced complete resolution of leg pain following the surgical intervention.
• Beaton type d anatomical variation was identified as the cause of the piriformis syndrome.

Implications:

• This case highlights the successful surgical management of a rare piriformis syndrome variant.
• Pelvic MRI and sciatic nerve perineurography are valuable diagnostic tools for this condition.
• Understanding anatomical variations is crucial for diagnosing and treating piriformis syndrome effectively.