Síndrome do piriforme: diagnóstico e tratamento: um estudo retrospectivo
DOI:
https://doi.org/10.34019/1982-8047.2022.v48.36411Keywords:
Nervo Isquiático, Síndromes de Compressão Nervosa, CiáticaAbstract
Introduction: The piriformis muscle syndrome is a disease with painful symptoms that make up the differential diagnosis of sciatica. It is an infrequent and poorly understood disease, with a probable involvement between the piriformis muscle and its relationship with the sciatic nerve. Conservative therapy is the most frequent and there are no national studies on diagnostic characteristics and orthopedic treatment. Objectives: to evaluate, in a retrospective study, the epidemiological characteristics of patients with piriformis syndrome and the results of the treatment instituted. Methods: primary, observational, retrospective study of patients seen at the orthopedics and traumatology clinic, specialized in hip diseases, from January 2010 to December 2018, diagnosed with piriformis syndrome, and evaluated by a form with a simplified scale of grading of symptoms. Results: 34 participants, with a mean follow-up of 12 months (minimum 06, maximum of 18 months), mean age of 49 years. A positive isolated clinical test was not identified in the entire sample. Conservative treatment had excellent results in 23 patients (67.6%), good in nine patients (26.4%) and fair (unsatisfactory) in two patients (5.8%), these with a previous history of hip trauma. Conclusions: Piriformis Syndrome (PS) is an infrequent diagnosis, usually late, eminently clinical, but a positive isolated clinical test was not identified in all patients. In most cases, satisfactory results were observed with conservative and non-invasive treatment.
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References
Yeoman W. The relation of arthritis of the sacroiliac joint to sciatica: with an analysis of 100 cases. Lancet. 1928; 2:1119-22.
Robinson D. Piriformis muscle in relation to sciatic pain. Am J Surg. 1947; 73:355-8.
Freiberg AH. Sciatic pain and its relief by operations on muscle and nerve. Arch Surg. 1937; 34:337-49.
Thomas Byrd JW. Piriformis syndrome. Oper Tech Sports Med. 2005; 13:71-9.
Kouvalchouk JF, Bonnet JM, deMondnerd JP. Pyramidal syndrome: apropos of 4 cases treated by surgery and review of the literature. Rev Chir Orthop Reparatrice Appar Mot. 1996; 82(7):647-57.
Güvencer M, Akyer P, Iyem C, Tetik S, Naderi S. Anatomic considerations and the relationship between the piriformis muscle and the sciatic nerve. Surg Radiol Anat. 2008; 30:467-74.
Papadopoulos EC, Khan SN. Piriformis syndrome and low back pain: a new classification and review of the literature. Orthop Clin North Am. 2004; 35(1):65-71.
Pecina HI, Boric I, Smoljanovic T, Duvancic D, Pecina M. Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome. Skeletal Radiol. 2008; 37:1019-23.
Boyajian-O’Neill LA, McClain RL, Coleman MK, Thomas PP. Diagnosis and management of piriformis syndrome: an osteopathic approach. JAOA. 2008; 108(11):657-64.
Turtas S, Zirattu G. The piriformis syndrome: a case report of an unusual cause of sciatica. J Orthopaed Traumatol. 2006; 7:97-9.
Lee EY, Margherita AJ, Gierada DS, Narra VR. MRI of piriformis syndrome. AJR Am J Roentgenol. 2004; 183(1):63-4.
Mayrand N, Fortin J, Descarreaux M, Normand MC. Diagnosis and management of posttraumatic piriformis syndrome: a case study. J Manipulative Physiol Ther. 2006; 29(6):486-91.
Benson ER, Schutzer SF. Posttraumatic piriformis syndrome: diagnosis and results of operative treatment. J Bone Joint Surg Am. 1999; 81(7):941-9.
Pecina M. Contribution to the ethiological explanation of the piriformis Syndrome Acta Anat. 1979; 105:181.
Titelman R. The piriformis muscle syndrome: a simple diagnostic maneuver. Neurosurgery. 1994; 35:545.
Pace JB, Nagle D. Piriform syndrome. Western J Med. 1976; 124:435-39.
Beatty RA. The piriformis muscle syndrome: a simple diagnostic maneuver. Neurosurgery. 1994; 34(3):512-4.
Fishman LM et al. Piriformis syndrome: diagnosis, treatment, and outcome: a 10 year study. Arch Phys Med Rehabil. 2002; 83(3):295-301.
Palys V. Peripheral ns examination. In: Palys V. Neurologic examination: Viktor’s notes for the neurology resident [Internet]. 2010. [citado em 15 out 2010]. Acesso em: http://neurologyresident.net/D.%20Diagnostics/D15.%20Neurologic%20Examination/D1.%20Neurologic%20Examination.pdf.
Vandertop WP, Bosm NJ. The piriformis syndrome: a case report. J Bone Joint Surg Am. 1991; 73:1095-97.
Keskula DR, Tamburello M. Conservative management of piriformis syndrome. J Athl Train. 1992; 27(2):102-10.
Hopayian K, Song F, Riera R, Sambandan S. The clinical features of the piriformis syndrome: a systematic review. Eur Spine J. 2010; 19(12):2095-109.
Brum KN, Alonso AC, Brech GC. Tratamento de massagem e acupuntura em corredores recreacionais com síndrome do piriforme. Arq Ciênc Saúde. 2009; 16(2):62-66.
Rossi P, Cardinali P, Serrao M, Parisi L, Bianco F, Bac S. Magnetic resonance imaging findings in piriformis syndrome: a case report. Arch Phys Med Rehabil. 2001; 82(4):519-21.
Chang CW, Shieh SF, Li CM, Wu WT, Chang KF. Measurement of motor nerve conduction velocity of the sciatic nerve in patients with piriformis syndrome: a magnetic stimulation study. Arch Phys Med Rehabil. 2006; 87(10):1371-5.
Pribut SM, Perri-Pribut A. Piriformis syndrome: the big mystery or a pain in the behind [Internet]. c2007. [citado em 19 set 2010]. Acesso em: http://www.drpribut.com/sports/piriformis.html.
Filler AG et al. Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. J Neurosurg Spine. 2005; 2(2):99-115.
Windisch G, Braun EM, Anderhuber F. Piriformis muscle: clinical anatomy and consideration of the piriformis syndrome. Surg Radiol Anat. 2007; 29(1):37-45.
Dezawa A, Kusano S, Miki H. Arthroscopic release of the piriformis muscle under local anesthesia for piriformis syndrome. Arthroscopy. 2003; 19(5):554-7.
McCrory P, Bell S. Nerve entrapment syndromes as a cause in the hip, groin and buttock. Sports Med. 1999; 27(4):261-74.
Polesello CV, Rosa MJ, Queiros MC. Dor glútea profunda: problema comum no consultório: revisão da literatura e relato do tratamento endoscópico de 3 casos. Rev Bras Ortop. 2011; 46(Suppl 2):56-63.
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Copyright (c) 2022 Elmano de Araújo Loures, Daniel Naya Loures, Gilmar Rodrigues da Silva, Heitor Teixeira Alves Carvalho, Adriano Fernando Mendes Junior
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