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http://dx.doi.org/10.3344/kjp.2020.33.4.305

Extra-spinal sciatica and sciatica mimics: a scoping review  

Siddiq, Md Abu Bakar (Physical Medicine and Rehabilitation Department, Brahmanbaria Medical College)
Clegg, Danny (School of Health and Social Care, London South Bank University)
Hasan, Suzon Al (Physical Medicine and Rehabilitation Department, Rajshahai Medical College)
Rasker, Johannes J (Faculty of Behavioral Management and Social Sciences, Psychology Health and Technology, University of Twente)
Publication Information
The Korean Journal of Pain / v.33, no.4, 2020 , pp. 305-317 More about this Journal
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.
Keywords
Buttocks; Chronic Pain; Low Back Pain; Lumbar Vertebrae; Myofascial Pain Syndrome; Osteitis; Piriformis Muscle Syndrome; Sciatica; Sciatic Nerve;
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Times Cited By KSCI : 4  (Citation Analysis)
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