Sciatic Nerve Pelvic Outlet Area Conformity Of Clinical Retrospective Study

Objective:Background and research purposes:The sciatic nerve pelvic outlet area compression has become a clinical problem because of its occult disease,various pathogenic factors,atypical clinical signs,and lack of effective and accurate clinical examination tools,and it is difficult to identify with spine disease.Despite the rich literature,it has caused a great deal of interference in the epidemiological study of the disease,which reason is that the current academic community is qualitatively confused about the definition of the disease and the cognition is not uniform.The aim of this study was to study the long-term therapeutic effects of compression interventions in the pelvic outlet region of the sciatic nerve and to discuss the pathogenesis,clinical definition,and indications for surgical treatment of the sciatic nerve in order to improve the accuracy of recording of epicardial pressure in the pelvic outlet region of the sciatic nerve,and offer advices.Research methods:In this study,44 cases of sciatic nerve pelvic outlet area compression cases from July 2013 to September 2017 in Bethune First Hospital of Jilin University were analyzed for follow-up analysis,with 36cases of pain and sensory disturbance alone,and 8 cases of merger dyskinesia.There are 44 cases in all,including 18 males and 26 females,aged 22 to 67 years,mean age(48.05±8.93)years old.There were 18cases on the left side and 26 cases on the right side.There were 5 cases with clear pathogenesis factors,4 cases with onset after massage,1 case with onset after riding the bicycle,and 39 cases had no clear predisposing factors.Thirty-five patients had been treated at spine surgery.Physical examination:44 patients showed pain and numbness in the affected buttocks and lower limbs,and 8 patients had claudication.Signs:Impaired area of??the affected side of the 33 patients was found in the lateral side of the lower leg,plantar and back of the foot;in 7 patients,the muscle strength of the anterior tibial muscle was less than grade 4;the muscle strength of the anterior tibial muscle in 1 patient was grade 0;the ipsilateral heel tendon reflexes of 4 patients decreased;39 cases of patients with positive ipsilateral piriformis tension test,44 cases of patients in the tenderness at the lower piriformis or piriformis body projection position and in the radiation down along the sciatic nerve;Tinel sign is positive in piriformis inferior mouth.Eight patients were significantly affected with hip-like sausage-like cords.All 44 patients received diagnostic blockade.Among them,30 patients had complete remission of symptoms after treatment and no recurrence after 6 months of follow-up.14 patients had no remission after surgical conservative treatment.14 cases had been in surgical treatment.During the operation,4 cases of pure piriformis hypertrophy were confirmed,3 cases of muscle hypertrophy and 3 cases of unnamed band clamping,2 cases of abnormal sciatic nerve branches,3 cases of transverse motion vein compression,and 1 case of epiphyseal hyperplasia of ankle joints,and one case of piriformis deficient with compression of gluteus maximus degeneration.All patients were treated with decompression,and the piriformis and obturator incisional muscles were cut off prophylactically,and 10 cases underwent microsurgical epidural lysis.All data were statistically analyzed using SPSS 21.0 software,and comparisons were made between univariate groups using theχ~2 test.P<0.05 indicates that the difference was statistically significant.Research result:The visual acuity assessment scale(VAS)score of patients in the surgical group was reduced from preoperative(8.3±0.8)to postoperative(4.4±0.9),and postoperative 12 months(3.1±0.9)points.P<0.0 was statistically significant significance.Evaluation criteria,excellent:symptoms completely disappeared,able to perform the original job and normal daily life;good:residual symptoms,does not affect the original work;so-so:partial relief of symptoms,affecting work;poor:symptoms without mitigation or aggravation.Treatment results of this group:excellent in 37 cases,good in 6 cases,so-so in 1 caseAnalysis conclusion:The sciatic nerve pelvic outlet area compression syndrome is a group of common symptoms of neuralgia of the lower extremities,the reason is changeable;preoperative sciatic nerve pelvic outlet nuclear magnetic scanning and preoperative diagnostic blocking therapy should be used as the main diagnostic criteria;and should pay attention to the posibility of the high nerve root and sciatic nerve"Double card pressure".Surgical release is a direct and effective treatment.