Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
권호 표지

Sciatic Pain Caused by Piriformis Syndrome

이상근 증후군에 의해 유발된 좌골신경통

Lee, Sang-Un;Kim, Ki-Tack;Cho, Yoon-Je;Ryu, Kyung-Nam;Chun, Young-Soo
이상언;김기택;조윤제;류경남;전영수

  • Published : 20050400
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Abstract

Purpose: Sciatic pain rarely develops from piriformis syndrome; thus, its differential diagnosis from other diseases associated with sciatic pain is essential. We analysed the clinical symptoms and radiological findings for the differential diagnosis of piriformis syndrome, and assessed the results of its treatment. Materials and Methods: We analysed five patients diagnosed with piriformis syndrome. Four patients were treated with a tenotomy. Of these, three had a history of misdiagnosis. The hypertrophied piriformis muscle was revealed with a compressed sciatic nerve in the operative field. We performed a tenotomy of the piriformis at the site of the tendinous insertion to decompress the sciatic nerve. Results: At the average follow up was 23.5 months, at which time no patients had any problems relating to tenderness and sciatic pain, and were able to return to normal activity one month postoperatively. All patients evaluated their postoperative clinical state as being better. Conclusion: Multiple approaches are essential for the diagnosis of piriformis syndrome. We can obtain the satisfactory results through a tenotomy of the piriformis for the decompression of the sciatic nerve in intractable cases as a conservative treatment.

목적: 좌골신경통은 드물게 이상근 증후군에 의해 발생하기도 하며 하지의 방사통으로 인해 좌골신경통을 유발하는 질환과의 감별이 필요하다. 저자들은 이상근 증후군에 의한 좌골신경통에 대한 진찰 소견 및 이의 치료 결과에 대한 분석을 하였다. 대상 및 방법: 이상근 증후군으로 진단받은 5예를 대상으로 하였으며 그 중 4예에서 수술적 치료를 시행하였다. 이 중 3예는 타질환으로 진단받은 병력이 있었다. 전례에서 좌골신경이 압박된 부위에 이상근이 비후되어 있는 소견이 관찰되었으며, 이상근의 근건유리술을 시행하였다. 결과: 수술 후 평균 23.5개월 추시하였으며, 전례에서 둔부의 압통 및 하지 방사통이 소실되었고, 수술 1개월 후에는 정상 생활로 복귀할 수 있었다. 결론: 이상근 증후군의 진단을 위해서는 임상적 소견, 이학적 소견 및 방사선학적 검사를 종합적으로 분석하는 것이 가장 중요하며 보존적 치료로 치료되지 않는 경우 근건유리술이 유용한 것으로 사료된다.

Keywords

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