Department of Anesthesiology and Pain Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea.
Medicine (Baltimore). 2022 Oct 21;101(42):e30950. doi: 10.1097/MD.0000000000030950.
Piriformis syndrome (PS) is neuromuscular disorder caused by sciatic nerve compression by piriformis muscle and related to sciatic-type pain. When the conservative care fails, local injection or surgery can be also performed into piriformis. In recent years, botulinum toxin (BoNT) has also been considered as a new therapeutic option of piriformis syndrome.
A man in his late 40s came to pain clinic for left low back pain. The symptom was aggravated with sitting position.
Piriformis syndrome.
The patient underwent BoNT injection with 100 IU with 2 mL into piriformis muscle for piriformis syndrome treatment, and his pain was relieved. However, it recurred 8 months later. BoNT injection was repeated with 100 IU with 5 mL.
At the time of this writing, his pain was reduced for 2 years without any medication.
We report a case of treating relapsed piriformis syndrome with BoNT injection of different dilution volume, suggesting that the higher the dilution volume, the more effective for therapeutic effect of BoNT.
梨状肌综合征（PS）是一种由梨状肌压迫坐骨神经引起的神经肌肉疾病，与坐骨神经痛有关。当保守治疗失败时，也可以对梨状肌进行局部注射或手术治疗。近年来，肉毒毒素（BoNT）也被认为是梨状肌综合征的一种新的治疗选择。
一名 40 多岁的男性因左侧腰痛到疼痛诊所就诊。症状在坐位时加重。
梨状肌综合征。
患者接受了 BoNT 注射，将 100IU 的 BoNT 用 2mL 稀释液注入梨状肌，以治疗梨状肌综合征，其疼痛得到缓解。然而，8 个月后症状再次复发。再次给予 BoNT 注射，用 5mL 稀释液注入 100IU 的 BoNT。
截至本文撰写时，患者的疼痛已缓解 2 年，无需任何药物治疗。
我们报告了一例使用不同稀释体积的 BoNT 注射治疗复发的梨状肌综合征的病例，提示 BoNT 的稀释体积越高，治疗效果越好。
