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C0104 Deep gluteal syndrome
  1. Raul Albalate Barbero
  1. Fisiovitally Centro Clínico Madrid, Madrid, España


Background It is understood by deep gluteal Syndrome (DGS) the set of symptoms and signs caused by compression of non discogenic sciatic nerve origin in the anatomical region of subgluteal space. It is common to be 6% to 8% of the causes of sciatic pain.

This term defines the sciatic nerve compression in the anatomical region of space gluteus not discogenic causing those originating this region. This syndrome has a high prevalence but low diagnosis. There are numerous causes that can lead to their involvement and level compression that space.

Methods A case study. 45 year old woman with symptoms of sciatica. Ruled that the origin of the posterior hip pain is another examination of the lumbar spine, sacroiliac joint and the hip, MR of the lumbosacral spine to rule originated in this area should also be included.

A convex transducer is used. The patient is placed in lateral decubitus or prone position and the transducer with the lateral mark oblique axis between ischial tuberosity and greater trochanter. Bone marks will be two half moons observed nerve deep and superficial gluteus the greater the femoral box. The needle is inserted through the piriformis muscle through it and finish saline solution (20 ml) is injected, ocal anesthetic (4 ml) followed by corticoid (1 ml). This increase in volume in the area may be sufficient to increase the space in which they find trapped nerve and break the adhesions that could have formed. As we remove inject in the thickness of the piriformis a little more corticoid and this completed the technique.

Results The patient may report improved almost instantly even if it did so it would not be reason for technique failure and we should see the evolution at 24 and 48 hours of it. The improvement usually lasts about several months.

Conclusions Ultrasound guided subgluteal deep infiltration using a mixture of saline, local anesthetic and a corticosteroid is a solution in patients with deep gluteal syndrome refractory to conservative treatment. It is a safe procedure that gave good preliminary results for symptom relief. The procedure could be an alternative to avoid surgery.

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