Sciatic Nerve Release/Piriformis Tenotomy: Endoscopic Surgery

Abstract

Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic and extrapelvic sciatic nerve entrapment in the subgluteal space. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. The whole sciatic nerve trajectory in the deep gluteal space can be addressed by an endoscopic surgical technique, allowing the treatment of the diverse causes of sciatic nerve entrapment. Endoscopic decompression of the sciatic nerve appears useful in improving function and diminishing hip pain in sciatic nerve entrapments within the subgluteal space.