Aguilera-Bohorquez B, Cardozo O, Brugiatti M, Cantor E, Valdivia N
Cirugía de Preservación y Artroscopia de Cadera, Pontificia Universidad Javeriana Cali, Centro Médico Imbanaco, Cali, Colombia.
Cirugía de Preservación y Artroscopia de Cadera, Pontificia Universidad Javeriana Cali, Centro Médico Imbanaco, Cali, Colombia.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2018 Sep-Oct;62(5):322-327. doi: 10.1016/j.recot.2018.03.004. Epub 2018 May 26.
Deep gluteal syndrome (DGS) is characterized by compression, at extra-pelvic level, of the sciatic nerve within any structure of the deep gluteal space. The objective was to evaluate the clinical results in patients with DGS treated with endoscopic technique.
Retrospective study of patients with DGS treated with an endoscopic technique between 2012 and 2016 with a minimum follow-up of 12 months. The patients were evaluated before the procedure and during the first year of follow-up with the WOMAC and VAIL scale.
Forty-four operations on 41 patients (36 women and 5 men) were included with an average age of 48.4±14.5. The most common cause of nerve compression was fibrovascular bands. There were two cases of anatomic variant at the exit of the nerve; compression of the sciatic nerve was associated with the use of biopolymers in the gluteal region in an isolated case. The results showed an improvement of functionality and pain measured with the WOMAC scale with a mean of 63 to 26 points after the procedure (P<.05). However, at the end of the follow-up one patient continued to manifest residual pain of the posterior cutaneous femoral nerve. Four cases required revision at 6 months following the procedure due to compression of the scarred tissue surrounding the sciatic nerve.
Endoscopic release of the sciatic nerve offers an alternative in the management of DGS by improving functionality and reducing pain levels in appropriately selected patients.
深部臀肌综合征（DGS）的特征是坐骨神经在盆腔外水平受到深部臀肌间隙任何结构的压迫。目的是评估采用内镜技术治疗DGS患者的临床效果。
对2012年至2016年间采用内镜技术治疗的DGS患者进行回顾性研究，随访时间至少12个月。在手术前以及随访的第一年，使用WOMAC和VAIL量表对患者进行评估。
纳入了41例患者（36名女性和5名男性）的44例手术，平均年龄为48.4±14.5岁。神经受压最常见的原因是纤维血管束。有2例神经出口处的解剖变异；在1例孤立病例中，坐骨神经受压与在臀肌区域使用生物聚合物有关。结果显示，使用WOMAC量表测量的功能和疼痛有所改善，术后平均从63分降至26分（P<0.05）。然而，在随访结束时，1例患者仍表现出股后皮神经残留疼痛。4例患者在术后6个月因坐骨神经周围瘢痕组织受压需要进行翻修手术。
对于适当选择的患者，内镜下坐骨神经松解术通过改善功能和降低疼痛程度，为深部臀肌综合征的治疗提供了一种替代方法。
