A Piriformis Syndrome Diagnosed with Lomber Disc Herniation: 3 Cases Report

The piriformis syndrome is an entrapment neuropathy emerging with the compression of sciatic nerve by a muscle due to its close proximity with piriformis muscle. However its pathophysiology hasn’t been understood clearly, it is thought that it arises from the oedema and inflammation in the piriformis muscle. This syndrome, which we meet with sciatica table clinically, is often likened to lumbar disc herniation (LDH). Multidisciplinary, the treatment of piriformis syndrome may include the administration of nonsteroidal anti-inflammatory drugs (NSAID), muscle relaxants, physical therapy and interventional procedures. Treatment with diagnosis of LDH was applied to each three cases we shared (intradiscal intervention for two cases and micro discectomy by microsurgery for one case). Three patients, whose pain scores hadn’t been improved in the surveillance period, were evaluated in pain clinics. In comply with ultrasonography (USG) injection with 10 ml 0.25% bupivacaine and 40 mg methylprednisolone was administered to three patients who were diagnosed with piriformis through physical examination and imaging methods. Pre-treatment, post-treatment and post-treatment 1st and 3rd months VAS scores of the patients were recorded. 3 months VAS scores were found as pre-treatment (PT) VAS:6, after treatment (AT) VAS:3, AT 1st month VAS:3, AT 3rd month VAS:2 for 1st case, PT VAS:8, AT VAS:2, İS 1st month VAS:3, AT 3rd month VAS:2 for 2nd case, PT VAS:6, AT VAS:2, AT 1st month VAS:3, AT 3rd month VAS:2 for 3rd case. Diagnosis of piriformis syndrome is often likened to LDH. Injection administration in company with USG can be used for both diagnosis and treatment. We aimed to share 3 cases who were diagnosed with LDH before, to whom we administered injection in company with USG by diagnosing piriformis syndrome with examination and monitoring findings and VAS scores of whom were decreasing.