Priformis sendromu tedavisinde tetik nokta enjeksiyonu
Priformis kası sakrumun lateral kenarından kaynaklanan siyatik çentik üzerinden trokanter majöre doğru uzanan üçgen şeklinde bir kastır. Siyatik sinirin bu kas altındaki siyatik çıkıntıyı geçerken nadiren hasarlanması ile gelişen klinik tablo priformis sendromu olarak adlandırılır. Bu kas içinde gelişen tetik noktaları psödosiyataljiye neden olabilir. Bu olgu sunusunda, lumbal diskopati semptomları altında gizlenmiş priformis sendromuna ve onun tetik nokta enjeksiyonu ile başarılı tedavisine dikkat çekmeyi amaçladık.
Trigger point injection in the mangement of priformis syndrome
The priformis muscle originates in the lateral margin of the sacrum and passes through the greater sciatic notch to attach to the greater trochanter. The sciatic nerve is rarely damaged at the sciatic notch as it passes through the greater sciatic notch below the priformis muscle, which is called as priformis syndrome. Trigger points are mechanical overloads of the priformis muscle to refer pain as a pseudosciatica pattern in our case. Here we aimed to attract the attention of the clinicians for priformis syndrome hidden under the symtomps of the lumbar discopathy and successful intervention with trigger point injection.
___
- 1.Boyajian-O'Neill LA, McClain RL, Coleman MK, Thomas PP. Diagnosis and management of priformis syndrome: an osteopathic approach. J Am Osteopath Assoc. 2008 Nov; 108(11): 657- 64.
- 2.Broadhurst NA, Simmons DN, Bond MJ. Priformis syndrome: Correlation of muscle morphology with symptoms and signs. Arch Phys Med Rehabil. 2004 Dec; 85(12): 2036- 9.
- 3.Guvençer M, Akyer P, iyem C, Tetik S, Naderi S. Anatomic considerations and the relationship between the priformis muscle and the sciatic nerve. Surg Radiol Anat. 2008 Aug; 30(6): 467- 74.
- 4.Windisch G, Braun EM, Anderhuber F. Priformis muscle: clinical anatomy and consideration of the priformis syndrome. Surg Radiol Anat. 2007 Feb; 29(1): 37- 45.
- 5.Hulberta A, Dey leb GD. Differential diagnosis and conservative treatment for piriformis syndrome: a review of the literature. Curr Orthop Pract. 2009 Jun; 20(3): 313- 9.
- 6.Benzon HT, Katz JA, Benzon HA Iqbal MS. Priformis syndrome: anatomic considerations, a new injection technique, and a review of the literature. Anesthesiology. 2003 Jun; 98(6): 1442- 8.
- 7.Kosukegawa I, Yoshimoto M, Isogai S, Nonaka S, Yamashita T. Priformis syndrome resulting from a rare anatomic variation. Spine (Phila Pa 1976). 2006 Aug; 31(18): E664-6.
- 8.Yeoman W. The relation of arthritis of the sacro-iliac joint to sciatica, with an analysis of 100 cases. Lancet. 1928 Dec; 212 (5492): 1119-1123.
- 9.Robinson DR. Pyriformis syndrome in relation to sciatic pain. Am J Surg. 1947 Mar; 73(3): 355-8.
- 10.Kobbe P, Zelle BA, Gruen GS. Case report : recurrent priformis syndrome after surgical release. Clin Orthop Relat Res. 2008 Jul; 466(7): 1745-8
- 11.Gonzalez P, Pepper M, Sullivan W, Akuthota V. Confirmation of needle placement within the priformis muscle of a cadaveric specimen using anatomic landmarks and fluoroscopic guidance. Pain Physician. 2008 May-Jun; 11(3): 327- 33.
- 12.Hughes MS, Burd TA, Allen WC. Post-traumatic catamenial sciatica. Orthopedics. 2008 Apr; 31(4): 400.
- 13.Benson ER, Schutzer SF. Posttraumatic priformis syndrome: diagnosis and results of operative treatment. J Bone Joint Surg Am. 1999 Jul; 81(7): 941- 9.
- 14.Naja Z, Al-Tannir M, El-Rajab M et al. The effectiveness of clonidine-bupivacaine repeated nevre stimulator-guided injection in priformis syndrome. Clin J Pain. 2009 Mar-Apr; 25(3): 199-205.
- 15.Hanania M, Kitain E. Perisciatic injectin of steroid for the treatment of sciatica due to priformis syndrome. Reg Anesth Pain Med. 1998 Mar-Apr; 23(2): 223- 8
- 16.Lang AM. Botulinum toxin type B in priformis syndrome. Am J Phys Med Rehabil. 2004 Mar; 83(3): 198-202.