Background The study included 11 patients; seven males
and four females with mean age of 68.3±11 years. All
patients had sciatic nerve entrapment: three had a penetrating
injury, three suffered postoperative trauma, two
had a crush injury, two had inadvertent injections and
one was trapped in a machine belt. Clinical examination
included: an evaluation of the extent of motor and
sensory impacts according to the British Medical Research
Council (BMRC) scale and the Semmes-
Weinstein monofilament test; assessment of pain sensation
using the visual analogue scale (VAS); electromyography;
and nerve conduction velocitiey determination.
The applied operative procedure for sciatic neurolysis
was modulated according to the suspected site of sciatic
nerve entrapment. At 6 and 12 months after surgery all
patients were evaluated for recovery of motor and sensory
function.
Results All patients passed the smooth intraoperative
course within a mean operative time of 77.7±21 min.
The mean duration of wound drainage and postoperative
hospital stay was 2.6±0.7 and 4.8±0.8 days, respectively.
Pain sensation showed progressive significant improvement
in nine patients but decreased at time of
discharge and remained stationary till 12-m post-operative
(PO). Recovery of motor function showed progressive
significant improvement at 6 and 12 months after
sciatic nerve neurolysis. The frequency of patients having
muscle power recovery and regained sensation was
significantly higher at 6-m and 12-m PO as compared to
preoperative grading with a significantly higher frequency
at the 6-m grading compared to preoperative grading.
Two patients showed no change of their muscle strength
grade, while nine patients showed improvement for a
total success rate of motor strength recovery of 81.8%.
At 6- m PO five patients showed no change of their
sensory group, while six patients showed improvement
for a total success rate of sensation recovery of 54.5%.
At 12-m PO ten patients had fullly recovered protective
sensation for a success rate of 90.9%.
Conclusion Surgical exploration and neurolysis of cases with
sciatic nerve entrapment is a safe and effective therapeutic
modality with significant improvement of both motor and
sensory functions without risk of additional deficit secondary
to neurolysis. |
