JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

Endoscopically assisted piriformis-to-knee surgery of sciatic, peroneal, and tibial nerves: technical note.

Neurosurgery 2015 March
BACKGROUND: Proximal lesions of the sciatic nerve are often difficult to diagnose and to treat properly. In particular, if there are posttraumatic or postoperative alterations, imaging might not identify the level and location of lesion. Due to the sciatic nerve anatomy, the same is true for clinical and electrophysiological evaluation with a risk of delayed surgery and, thus, unsuccessful surgery. Therefore, in some unclear cases, surgical exploration of the whole sciatic nerve and its divisions could be the only means to determine the correct diagnosis and allow prompt treatment to produce the best clinical outcome.

OBJECTIVE: To describe a novel minimally invasive technique to explore and treat patients with proximal sciatic, peroneal, and tibial nerve lesions. Intraoperative findings, surgical considerations, and complications are presented.

METHODS: From January 2012 to November 2013, 9 consecutive patients with lesions of the sciatic, peroneal, and tibial nerves underwent endoscopy and were treated. The technical considerations of these cases are presented with regard to the retrospectively collected clinical and surgical data to evaluate the pros and cons of the technique.

RESULTS: A subgluteal incision, as the primary endoscopic port, was used in all 9 patients. An additional mid-thigh and fibular head incision was thought necessary in 3 patients. An extension of the approach by a secondary transgluteal incision was performed in 4 patients. In 2 of these sciatic lesions, autologous nerve grafts were placed. One perineurioma was detected and bioptically secured. There were no complications. Six patients experienced pain relief; in 6, we observed motor improvement. The mean follow-up was 9.5 months.

CONCLUSION: The endoscopically assisted single- to multiportal sciatic exploration technique provides excellent visualization that enables nerve inspection, lesion detection, and decompression, and obviates the need for more extensive approaches in cases of unclear sciatic nerve pathology. By adding several ports, whole-length exploration of the sciatic from the notch to fibular head level is feasible.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app