Clinical Characteristics of Sciatica in Patients with Piriformis Syndrome Improved by Decompression Surgery

Abstract

Objective: To clearly identify the symptoms of sciatica in patients with piriformis syndrome, we retrospectively reviewed patients whose symptoms significantly improved over long-term postoperative follow-up. Methods: Among patients who underwent sciatic nerve decompression for piriformis syndrome over the past 3 years, the preoperative sciatic pain symptoms of 32 patients whose symptoms were confirmed to have improved by more than 50% during more than 1 year of follow-up were analyzed. To identify the characteristics of sciatic pain in piriformis syndrome, we investigated pain when sitting, pain when resting, pain when standing or walking, and pain when resting at night. In addition, the distribution of sciatic pain in the lower back, buttocks, lower extremities, and feet was investigated. Results: The most common symptom was pain when sitting, which was present in 25 patients (81%). Pain characteristically occurred even at rest, occurring in 62.5% of patients while lying down at night and in 53.1% of patients during daytime rest. Sciatic pain from piriformis syndrome was most commonly distributed in the buttock (90.6%) and also present in the lower back (37.5%). Pain was present in the posterior thigh in 23 patients (71.9%), in the calf in 68.8% of patients, and in the foot in 50% of patients. Conclusion: Buttock pain exacerbated by sitting was the most common pattern of pain in patients with piriformis syndrome. However, the sciatic pain of this disease was also found to be characterized by pain that persisted even at rest.