Deep Gluteal Pain Syndrome: Endoscopic Technique and Medium-Term Functional Outcomes

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Minimally Invasive Procedures

Background:

• Sciatic nerve entrapment causes significant pain, often exacerbated by sitting.
• Fibrovascular bands are frequently implicated as the cause of sciatic nerve entrapment.
• Endoscopic sciatic nerve decompression, often with piriformis tenotomy, is an established treatment.

Purpose of the Study:

• To evaluate the medium-term functional outcomes of endoscopic sciatic nerve release.
• To assess the efficacy of this procedure specifically without piriformis tenotomy.

Main Methods:

• Prospective observational study of 57 patients with sciatic nerve entrapment.
• Procedures performed between January 2014 and January 2019.
• Functional outcomes assessed using modified Harris hip score (mHHS), International Hip Outcome Tool (iHOT-12), and visual analog scale (VAS) for pain.

Main Results:

• Significant improvements observed in median mHHS (59 to 85) and iHOT-12 (60 to 85) scores.
• Median VAS pain scores decreased substantially from 7 to 2.
• 12% of patients experienced postoperative complications, including hematoma and sensory disturbances.

Conclusions:

• Endoscopic release of sciatic nerve entrapment by resecting fibrovascular bands, without piriformis tenotomy, yields good to excellent functional results.
• This technique demonstrates outcomes comparable to those reported for procedures including piriformis tenotomy.