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Injection of the piriformis muscle by fluoroscopic and electromyographic guidance
S M Fishman1, O A Caneris, T B Bandman
1MGH Pain Center, Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston 02114, USA.
Background:
There is not a universally accepted single technique for injection of the piriformis muscle that has validated exact placement of the needle tip within the piriformis muscle.
Objective:
We sought a methodology that would precisely document needle placement within the piriformis muscle that is reliable, relatively uncomplicated, and reproducible.
Methods:
Patients with piriformis syndrome underwent injections of the piriformis muscle under fluoroscopic and electromyographic guidance. This technique used electrophysiological confirmation of needle placement within the piriformis muscle and image-guided identification of the piriformis muscle with radiopaque contrast media under fluoroscopy.
Results:
Using this methodology, injections on 17 occasions in 11 patients resulted in needle placement within the piriformis muscle.