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Extra-spinal sciatica and sciatica mimics: a scoping review

Korean Journal of Pain 2020년 33권 4호 p.305 ~ 317
Siddiq Md Abu Bakar, Clegg Danny, Al Hasan Suzon, Rasker Johannes J.,
소속 상세정보
 ( Siddiq Md Abu Bakar ) - Brahmanbaria Medical College Physical Medicine and Rehabilitation Department
 ( Clegg Danny ) - London South Bank University School of Health and Social Care
 ( Al Hasan Suzon ) - Rajshahai Medical College Physical Medicine and Rehabilitation Department
 ( Rasker Johannes J. ) - University of Twente Faculty of Behavioral Management and Social Sciences, Psychology Health and Technology

Abstract


Not all sciatica-like manifestations are of lumbar spine origin. Some of them are caused at points along the extra-spinal course of the sciatic nerve, making diagnosis difficult for the treating physician and delaying adequate treatment. While evaluating a patient with sciatica, straightforward diagnostic conclusions are impossible without first excluding sciatica mimics. Examples of benign extra-spinal sciatica are: piriformis syndrome, walletosis, quadratus lumborum myofascial pain syndrome, cluneal nerve disorder, and osteitis condensans ilii. In some cases, extra-spinal sciatica may have a catastrophic course when the sciatic nerve is involved in cyclical sciatica, or the piriformis muscle in piriformis pyomyositis. In addition to cases of sciatica with clear spinal or extra-spinal origin, some cases can be a product of both origins; the same could be true for pseudo-sciatica or sciatica mimics, we simply don’t know how prevalent extra-spinal sciatica is among total sciatica cases. As treatment regimens differ for spinal, extra-spinal sciatica, and sciatica-mimics, their precise diagnosis will help physicians to make a targeted treatment plan. As published works regarding extra-spinal sciatica and sciatica mimics include only a few case reports and case series, and systematic reviews addressing them are hardly feasible at this stage, a scoping review in the field can be an eye-opener for the scientific community to do larger-scale prospective research.

키워드

Buttocks; Chronic Pain; Low Back Pain; Lumbar Vertebrae; Myofascial Pain Syndrome; Osteitis; Piriformis Muscle Syndrome; Sciatica; Sciatic Nerve

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