Injection injury of the sciatic nerve (370 cases)

Injury to peripheral nerves due to injections of therapeutic and other agents is common. The postulated mechanisms of injury include direct needle trauma, secondary constriction by scar, and direct nerve fiber damage by neurotoxic chemicals in the injected agent. Neurological sequelae can range from minor transient sensory disturbance to severe sensory disturbance and paralysis with poor recovery. The recommended treatment has ranged from a conservative approach to immediate operative exposure and irrigation, and has also included early neurolysis or delayed exploration with neurolysis or resection and anastomosis. We present 370 cases of injection injury of the sciatic nerve in children treated during the last 20 years at the Neurosurgical Department of the Hospital La Paz in Madrid, Spain. Pathology, clinical course, treatment, and results are discussed.