Marco C, Miguel-Pérez M, Pérez-Bellmunt A, Ortiz-Sagristà J C, Martinoli C, Möller I, Ortiz Miguel S, Agulló P
Unidad de Anatomía y Embriología Humana, Departamento de Patología y Terapéutica Experimental, Facultad de Medicina y Ciencias de la Salud (Campus de Bellvitge), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España.
Unidad de Anatomía y Embriología Humana, Departamento de Patología y Terapéutica Experimental, Facultad de Medicina y Ciencias de la Salud (Campus de Bellvitge), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2019 Nov-Dec;63(6):424-430. doi: 10.1016/j.recot.2019.06.002. Epub 2019 Jul 29.
The piriformis syndrome is one of the etiologies of pelvic pain due to the sciatic nerve's entrapment by the piriformis muscle. Nowadays this syndrome might be difficult to be diagnosed. The aim of this study is to know the prevalence of anatomic variations in our population that may contribute to the appearance of piriformis syndrome. Furthermore, anthropometric measurements of the piriformis muscle and the sciatic nerve procedures are studied for a possible application in the gluteal region.
The study was carried out in 59 pelvis of 32 cryopreserved bodies. The anatomical variations of piriformis and sciatic nerve founded were described following the Beaton and Anson's classification. Anthropometric measurements of both structures with reference to the greater trochanter of the femur were performed.
The sciatic nerve and the piriformis had an anatomical variation in a 28.13%. The most frequent variation found was tipus II (21.64%) and tipus III (6.49%).Insertion most frequently observed was an independent piriformis tendon inserted into the trochanteric fossa with 53.85%.
The anatomic variations' incidence in the population studied indicates that those have to be evaluated as a differential diagnosis of gluteal region pain due to the symptoms and signs resemblance with the vertebral disc pathology involving nerve root injury. In addition, anatomical knowledge of this region can be useful for the interpretation of imaging techniques, especially when ultrasound-guided injections are performed.
梨状肌综合征是由于梨状肌卡压坐骨神经导致盆腔疼痛的病因之一。如今，这种综合征可能难以诊断。本研究的目的是了解我们人群中可能导致梨状肌综合征出现的解剖变异的患病率。此外，研究梨状肌的人体测量学测量和坐骨神经手术，以便在臀区可能应用。
该研究在32具冷冻保存尸体的59个骨盆中进行。根据比顿和安森的分类描述所发现的梨状肌和坐骨神经的解剖变异。对这两种结构相对于股骨大转子进行人体测量。
坐骨神经和梨状肌的解剖变异率为28.13%。最常见的变异是II型（21.64%）和III型（6.49%）。最常观察到的插入是独立的梨状肌腱插入转子窝，占53.85%。
在所研究人群中解剖变异的发生率表明，由于其症状和体征与涉及神经根损伤的椎间盘病变相似，这些变异必须作为臀区疼痛的鉴别诊断进行评估。此外，该区域的解剖学知识有助于解释成像技术，特别是在进行超声引导注射时。
