Endoscopic Technique: Sciatic Neurolysis and Piriformis Tendon Release for Treating Piriformis Syndrome

Piriformis syndrome (PS) is an underdiagnosed condition, caused by entrapment of the sciatic nerve by the piriformis muscle tendon and adhesions in the deep gluteal space. We present a step-by-step endoscopic technique with the patient in a prone position through a posterior approach. This approach provides improved orientation for tracking the sciatic nerve from distal to proximal, facilitating the release of all adhesions and concluding with a piriformis tendon release. This method aims to enhance surgical safety during the procedure.