ABSTRACT
The diagnosis of Piriformis syndrome has been ill defined to many orthopaedic surgeons, and commonly misdiagnosed. We present the diagnosis, surgical treatment and outcome of twenty two patients with piriformis syndrome between October 1995 and February 2002. The mean age was 56 years [range 28-90]. Only 2 patients [9%] gave a history of trauma to the ipsilateral buttock. All the patients complained of deep buttock pain, which radiated to the ankle, the calf, or the thigh. The symptoms were chronic with a mean of 70 months [range 12-192]. There was associated neurosensory loss in 11 patients [50%]. Buttock tenderness and symptoms were exacerbated by passive stretching and active contraction of the piriformis muscle. Pre-operative nerve conduction studies were positive in 11 of 20 patients [55%]. Every patient had surgical division of the piriformis tendon at the greater trochanter. Abnormal anatomy was identified in 6 cases [29%]. After a mean follow up of 52 months [range 11-86], seven [35%] of patients were cured, 3 [15%] were better, 8 [40%] were no different, 2 [10%] were worse than preoperatively and 2 had died of unrelated causes. Seventy five percent of patients said that with hindsight they would undergo surgery again. Surgery for piriformis syndrome in this selected group of patients led to an improvement or resolution of chronic symptoms in 50% of patients with minimal associated morbidity