Piriformis Syndrome: Anatomic Considerations, a New Injection Technique, and a Review of the Literature

@article{Benzon2003PiriformisSA,
  title={Piriformis Syndrome: Anatomic Considerations, a New Injection Technique, and a Review of the Literature},
  author={Honorio T Benzon and Jeffrey A. Katz and Hubert A Benzon and Muhammad Shakeel Iqbal},
  journal={Anesthesiology},
  year={2003},
  volume={98},
  pages={1442-1448}
}
BACKGROUND Piriformis syndrome can be caused by anatomic abnormalities. [] Key Method They retrospectively reviewed the charts of 19 patients who had received piriformis muscle injections, noting the site of needle insertion in terms of the distance from the lower border of the SIJ and the depth of needle insertion at which the motor response of the foot was elicited.
Piriformis Syndrome: Treatment of a Rare Cause of Posterior Hip Pain with Fluoroscopic-Guided Injection
TLDR
F fluoroscopy-guided percutaneous local anaesthetic and corticosteroid injection is a simple and effective piriformis syndrome treatment that can feasibly be effectively performed by orthopaedic surgeons.
Anatomical causes of compression of the sciatic nerve in the pelvis. Piriform syndrome
Variations of the piriformis and sciatic nerve with clinical consequence: A review
TLDR
Because the prevalence of the anomaly in piriformis syndrome patients is not significantly different from what is thought to be a normal population, it indicates that this anomaly may not be as important in the pathogenesis of piriformIS syndrome as previously thought.
Anatomic considerations and the relationship between the piriformis muscle and the sciatic nerve
TLDR
It is confirmed that the sciatic nerve (SN) is prone to be trapped in the test position, and diagnosis of this situation requires dynamic MR and MR neurography study.
Piriformis muscle: clinical anatomy and consideration of the piriformis Syndrome
TLDR
The anatomical causes for the piriformis syndrome are rare and a more precise workup is necessary to rule out more common diagnosis.
The majority of piriformis muscles are innervated by the superior gluteal nerve
TLDR
Based on the study, a single “nerve to piriformis” does not exist in the majority of specimens thus this term should be abandoned and it is concluded that this muscle is innervated by two to three nerves.
PIRIFORMIS SYNDROME: A REVIEW
TLDR
Management of piriformis syndrome includes nonsurgical and surgical interventions, which includes- nonsteroidal anti-inflammatory drugs, physical therapy, ultrasound, correction of biomechanical abnormality, lifestyle modifications, local anesthetic and/or steroid injection into the Piriformis muscle.
Anatomical variations between the sciatic nerve and the piriformis muscle: a contribution to surgical anatomy in piriformis syndrome
TLDR
Anatomical variations of the sciatic nerve around the piriformis muscle were present in 6.4 % of the limbs examined, which should be expected during surgical intervention of the region.
Ultrasound guided piriformis injection with confirmation of needle placement through electromyography.
TLDR
A 60-year-old male presented to the authors' clinic with lower back, left hip, and left buttock pain for 6 years and, to their knowledge, the first report of combined use of US with electromyography (EMG) confirmation of muscle placement for piriformis muscle injection is described.
Confirmation of needle placement within the piriformis muscle of a cadaveric specimen using anatomic landmarks and fluoroscopic guidance.
TLDR
The present study was the first study, to the authors' knowledge, that has confirmed the intramuscular position of the needle within the piriformis muscle of a cadaveric specimen using these anatomic landmarks and fluoroscopic guidance.
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References

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Perisciatic Injection of Steroid for the Treatment of Sciatica due to Piriformis Syndrome
TLDR
A perisciatic injection of steroid using simple landmarks and utilizing a nerve stimulator to locate and inject near the sciatic nerve and into the piriformis muscle is described.
Piriformis syndrome: a rational approach to management
[The piriformis syndrome].
A rare mentioned and therefore and often overlooked cause of low back pain with sciatica. The piriformis muscle arises from the anterior surface of the sacrum and inserts on the superior border of
Chronic pain syndromes and their treatment iii. the piriformis syndrome
TLDR
Having made a presumptive diagnosis, confirmation is gained by palpating the muscle itself via rectum or vagina and reproducing the pain by digital pressure, and if this test also is positive, the muscle is injected, the approach being either through the sciatic notch, from the perineum, or through the vagina.
Contribution to the etiological explanation of the piriformis syndrome.
TLDR
The author found that in 6.15% of cases the nervus peroneus communis passes between the tendinous parts of the m.
Piriformis muscle syndrome: an underdiagnosed cause of sciatica.
Electrophysiologic evidence of piriformis syndrome.
Injection of the Piriformis Muscle by Fluoroscopic and Electromyographic Guidance
The piriformis muscle syndrome. Sciatic nerve entrapment treated with section of the piriformis muscle.
TLDR
The piriformis muscle syndrome is characterized by symptoms and signs due to sciatic nerve entrapment at the greater sciatic notch and should be suspected as part of the differential diagnosis in cases of low back and hip or thigh pain.
Bipartite piriformis muscle: an unusual cause of sciatic nerve entrapment.
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