The piriformis syndrome—a special indication for botulinum toxin
Nervenarzt, ISSN: 1433-0407, Vol: 91, Issue: 2, Page: 99-106
2020
- 3Citations
- 17Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations3
- Citation Indexes3
- Captures17
- Readers17
- 16
Article Description
The piriformis syndrome (PiS) is a possible cause of gluteal pain radiating into the legs. From a pathophysiological anatomical point of view a division into primary and secondary PiS is made. A primary PiS is based on variants of the course of the sciatic nerve with respect to the piriformis muscle. A secondary PiS occurs as a result of hypertrophy, tension and hardening of the piriformis muscle. Muscular hypertrophy causes an impingement syndrome with pressure on the sciatic nerve in the infrapiriform foramen more often than course variants. A tentative diagnosis of PiS can be made based on anamnestic information, clinical signs of strain and the flexion adduction internal rotation (FAIR) test. If asymmetry or hypertrophy exists, the tentative diagnosis is substantiated with the representation of the piriformis muscle in computed tomography (CT). Thus, a CT-supported botulinum injection (BTX) into the piriformis muscle is indicated. This is a pathogenetic treatment approach leading to a reduction in volume. In most cases a single treatment is sufficient. Since there are no adverse consequences, the BTX into the piriformis muscle is also justified from a diagnostic and therapeutic point of view in cases of primary PiS if the clinical indications are clear and other causes can be ruled out. In an in-house case series the tentative diagnosis of PiS could be made for 19 patients and the effectiveness of BTX was confirmed.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85079034460&origin=inward; http://dx.doi.org/10.1007/s00115-020-00866-4; http://www.ncbi.nlm.nih.gov/pubmed/32020236; http://link.springer.com/10.1007/s00115-020-00866-4; https://dx.doi.org/10.1007/s00115-020-00866-4; https://link.springer.com/article/10.1007/s00115-020-00866-4
Springer Science and Business Media LLC
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