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Who Performs Piriformis Syndrome Surgery

Piriformis muscle release is a type of surgery that involves removing or releasing a portion of the piriformis muscle to relieve compression on the sciatic nerve. This procedure is typically performed using minimally invasive techniques, with small incisions made in the buttock area.

Open surgery vs endoscopic surgery for piriformis syndrome

Both sciatic nerve decompression and piriformis muscle release can be performed endoscopically and through open surgical procedures. The endoscopic approach typically results in lesser damage to the soft tissue and muscle, which may cause lesser post-surgical pain and a shorter recovery time. 3 Jackson TJ. Endoscopic Sciatic Nerve Decompression in the Prone Position-An Ischial-Based Approach. Arthrosc Tech. 2016.5(3):e637-642. http://doi.org/10.1016/j.eats.2016.02.020 Open surgery may be indicated when more anatomic structures are involved, and it may carry a higher risk of post-surgical complications, such as hematoma formation, infections, and long rehabilitation time, compared to the endoscopic approach. 4 Ham DH, Chung WC, Jung DU. Effectiveness of Endoscopic Sciatic Nerve Decompression for the Treatment of Deep Gluteal Syndrome. Hip Pelvis. 2018.30(1):29-36. http://doi.org/10.5371/hp.2018.30.1.29 , 5 Coulomb R, Khelifi A, Bertrand M, et al. Does endoscopic piriformis tentomy provide safe and complete tendon release? A cadever study. Orthop Traumatol Surg Res. 2018.104(8):1193-1197. http://doi.org/j.otsr.2018.02.018

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Who Performs Piriformis Syndrome Surgery

An orthopedic surgeon performs piriformis syndrome surgery, and a multidisciplinary team composed of a physiatrist, physical therapist, and primary care physician will typically be involved in the pre-and-post surgical processes. 6 Vij N, Kiernan H, Bisht R, et al. Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review. Anesth Pain Med.2021.11(1):e112825. http://doi.org/10.5812/aapm.112825

Long-Term Outcomes of Piriformis Syndrome Surgery

Research indicates that piriformis surgery may provide substantial relief from piriformis syndrome symptoms. Pain relief is usually long-lasting, with most patients experiencing complete resolution of their symptoms for several years after the surgery. 7 Fahmi A, Rahmadhan MA, Aprianto DR, Subianto H, Turchan A. Complete resolution of recurrent piriformis syndrome after piriformis resection with 3 years follow up: A case report. International Journal of Surgery Case Reports. 2020.77:576-579. http://doi.org/10.1016/j.ijscr.2020.11.099

A large study evaluating the post-surgical outcome of 239 patients treated for piriformis syndrome found that1:

  • Around 83% of patients who underwent surgical procedures experienced satisfactory results.
  • No post-surgical complications were observed during the 1-year follow-up.

As with any surgical procedure, there are potential risks and complications involved, and patients should discuss these risks with their surgeon before deciding on surgery.

Risks and Complications of Piriformis Syndrome Surgery

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