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梨状肌切除术后复发性梨状肌综合征完全缓解并随访3年:一例报告

Complete resolution of recurrent piriformis syndrome after piriformis resection with 3 years' follow up: A case report.

作者信息

Fahmi Achmad, Rahmadhan Mustaqim Apriyansa, Aprianto Dirga Rachmad, Subianto Heri, Turchan Agus

机构信息

Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Department of Neurosurgery, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Department of Neurosurgery, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

出版信息

Int J Surg Case Rep. 2020;77:576-579. doi: 10.1016/j.ijscr.2020.11.099. Epub 2020 Nov 20.

Abstract

INTRODUCTION

Piriformis syndrome (PS) is an uncommon neuromuscular condition characterized by buttock pain radiating to the leg. Although the goal of PS treatment is symptom relief, it is difficult in some patients using conservative treatment alone.

PRESENTATION OF CASE

A 72-year-old male underwent piriformis resection after failed sequential steroid injection of the piriformis. The patient ultimately underwent surgery for resection of the piriformis muscle and experienced satisfactory pain relief (pain reduction > 75% according to visual analog scale for at least 12 months) following surgery and in the 3-year follow-up period.

DISCUSSION

Conservative treatment is first-choice treatment for managing PS. Surgery was indicated when the patient did not achieve satisfactory pain relief with conservative treatment. Surgical resection of the piriformis muscle has been shown to be effective and feasible.

CONCLUSION

Piriformis resection is effective and can be a feasible option for the treatment of PS following failure of appropriate conservative treatment(s).

摘要

引言

梨状肌综合征(PS)是一种罕见的神经肌肉疾病,其特征为臀部疼痛并向腿部放射。尽管PS治疗的目标是缓解症状,但对于一些仅采用保守治疗的患者而言,实现这一目标颇具难度。

病例介绍

一名72岁男性在梨状肌序贯注射类固醇治疗失败后接受了梨状肌切除术。该患者最终接受了梨状肌切除手术,术后及3年随访期间疼痛得到了满意缓解(根据视觉模拟量表,疼痛减轻>75%,且持续至少12个月)。

讨论

保守治疗是管理PS的首选治疗方法。当患者通过保守治疗未能获得满意的疼痛缓解时,则需考虑手术治疗。梨状肌手术切除已被证明是有效且可行的。

结论

梨状肌切除有效,对于适当的保守治疗失败后的PS治疗而言,它可能是一种可行的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5cb/7708764/aa79dc46231b/gr1.jpg

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