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Endoscopic Sciatic Nerve Decompression After Fracture or Reconstructive Surgery of the Acetabulum in Comparison With Endoscopic Treatments in Idiopathic Deep Gluteal Syndrome

Park, Myung-sik, MD, PhD*,†,‡; Jeong, Seong-Yep, MD*,†,‡; Yoon, Sun-Jung, MD, PhD*,†,‡

Clinical Journal of Sport Medicine: May 2019 - Volume 29 - Issue 3 - p 203–208
doi: 10.1097/JSM.0000000000000504
Original Research
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Objective: The purpose of this study was to assess the endoscopic findings of the sciatic nerve and clinical outcomes of major traumatic sciatic nerve neuropathies after fracture or reconstructive surgery of the acetabulum with idiopathic deep gluteal syndrome (DGS) groups.

Design: Retrospective review of patient reports.

Setting: Level I trauma center of a tertiary university hospital.

Participants: The study included 70 patients who consecutively underwent endoscopic sciatic nerve decompression. Patients who had previous fractures or reconstructive surgeries of the acetabulum were categorized as the major trauma group, whereas those without major trauma were categorized as the idiopathic group (45 patients) after a minimum of 24-months of follow-up period.

Main Outcome Measures: The results were evaluated using the modified Harris Hip Score (mHHS), Hip outcome, and 12-Item Short Form Health Survey scores, respectively.

Results: In the major trauma group, all patients with sensory symptoms showed some degree of relief after the endoscopic sciatic nerve release. None of the patients with complete foot drop demonstrated complete improvement. Three patients with motor weakness without foot drop showed complete improvement in motor function. The mean mHHS increased from 61.5 ± 13.4 to 84.1 ± 8.1 (P = 0.031). In the idiopathic DGS group, the mean mHHS increased from 73.8 ± 10.3 to 94.4 ± 5.3 (P = 0.003). The Benson outcomes rating in the major trauma group was statistically lower than that in the idiopathic DGS group.

Conclusion: Endoscopic release of the sciatic nerve after fractures or reconstructive surgeries could provide some improvements without complications. However, more favorable outcomes were observed in the idiopathic DGS group.

*Department of Orthopedic Surgery, Chonbuk National University Hospital, Jeonju, South Korea;

Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, South Korea; and

Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, South Korea.

Corresponding Author: Sun-Jung Yoon, MD, PhD, Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Chonbuk National University, 20, Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54907, South Korea (sjyoon_kos@naver.com).

Supported by funds from the Biomedical Research Institute, Chonbuk National University Hospital.

The authors report no conflicts of interest.

Received March 01, 2015

Accepted June 27, 2017

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.