Article

Piriformis Muscle Syndrome (PMS) is caused by sciatic nerve
compression in the infrapiriformis canal. However, the pathology is poorly
understood and difficult to diagnose. This study aimed to devise a clinical
assessment score for PMS diagnosis and to develop a treatment strategy. METHODS: Two hundred and fifty patients versus 30 control patients with
disco-radicular conflict, plus 30 healthy control subjects were enrolled. A range
of tests was used to produce a diagnostic score for PMS and an optimum treatment
strategy was proposed. RESULTS: A 12-point clinical scoring system was devised
and a diagnosis of PMS was considered 'probable' when greater or equal to 8.
Sensitivity and specificity of the score were 96.4% and 100%, respectively, while
the positive predictive value was 100% and negative predictive value was 86.9%.
Combined medication and rehabilitation treatments had a cure rate of 51.2%.
Hundred and twenty-two patients (48.8%) were unresponsive to treatment and
received OnabotulinumtoxinA. Visual Analogue Scale (VAS) results were 'Very
good/Good' in 77%, 'Average' in 7.4% and 'Poor' in 15.6%. Fifteen of 19 patients
unresponsive to treatment underwent surgery with 'Very good/Good' results in 12
cases. CONCLUSIONS: The proposed evaluation score may facilitate PMS diagnosis
and treatment standardisation. Rehabilitation has a major role associated in half
of the cases with botulinum toxin injections.
CI - Copyright (c) 2013 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS ; FRANCAIS