• Clinics in Shoulder and Elbow
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• 제7권2호
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• pp.103-107
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• 2004

We present a case of suprascapular entrapment syndrome by a lipoma that compressed inferior branch of suprascapular nerve at the spinoglenoid notch and treated successfully by surgical excision.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.95-98
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• 2010

Purpose: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. Methods: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. Results: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. Conclusion: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.

• The Korean Journal of Pain
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• 제26권3호
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• pp.291-294
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• 2013

There are various origins for chronic abdominal pain. About 10-30% of patients with chronic abdominal pain have abdominal wall pain. Unfortunately, abdominal wall pain is not thought to be the first origin of chronic abdominal pain; therefore, patients usually undergo extensive examinations, including diagnostic laparoscopic surgery. Entrapment of abdominal cutaneous nerves at the muscular foramen of the rectus abdominis is a rare cause of abdominal wall pain. If abdominal wall pain is considered in earlier stage of chronic abdominal pain, unnecessary invasive procedures are not required and patients will reach symptom free condition as soon as the diagnosis is made. Here, we report a case of successful treatment of a patient with abdominal cutaneous nerve entrapment syndrome by ultrasound guided injection therapy.

• 대한족부족관절학회지
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• 제12권2호
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• pp.227-229
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• 2008

We experienced a case of an athlete with a painful mass on the distal peroneal musculature after sports activity, and diagnosed as the entrapment syndrome of superficial peroneal nerve. We treated the case with the mini-open and subcutaneous fasciotomy to release the entrapped peroneal nerve. We report the case with a review of the literature.

• Journal of Acupuncture Research
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• 제41권2호
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• pp.87-95
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• 2024

This review aims to analyze the efficacy of acupotomy in treating superior cluneal nerve entrapment syndrome (SCNES) by summarizing the findings of randomized controlled trials (RCTs). The RCTs were retrieved from seven databases (i.e., the Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, Korean Studies Information Service System, Research Information Service System, and Oriental Medicine Advanced Searching Integrated System). Seven RCTs were selected for this review. The results indicate that acupotomy is promising for providing significant pain relief and improving function in patients with SCNES. However, more high-quality RCTs are required to establish the long-term effectiveness and safety of acupotomy. This review provides valuable insights for clinicians and researchers in the management of SCNES.

• Journal of Yeungnam Medical Science
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• 제38권2호
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• pp.148-151
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• 2021

Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock's canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.

• 대한정형외과스포츠의학회지
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• 제1권1호
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• pp.65-70
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• 2002

목적 : 결절종에의해발생한견갑상 신경포착증후군환자에서수술적치료후결과를분석하고치료방법의개선을찾고자하였다. 대상및방법 : 1996년3월부터2001년5월까지진찰소견, 근전도, 자기공명영상소견에서결절종에의한견갑상신경포착증후군으로진단받은 13명의환자를대상으로하였다. 수술은결절종의개방적절제및감압술과관절경하검사를시행하였으며수술후의평가는근력의주관적인회복정도와American shoulder elbow surgeon (ASES)의평가법을이용하여분석하였다. 결과 : 수술후9예(69$\%$)에서간헐적인동통, 근력의불완전회복, 근위축의잔류로인한증상의지속소견이관찰되었으며4예(31$\%$)에서증상의완전회복소견을보였다. 수술후ASES 점수는평균86.4(70$\~$99.8)점이었으며수술전에비해수술후84$\%$의환자에서동통의호전과53$\%$의환자에서근력의호전을보였으나근위축은남아있었다. 결론 : 결절종에의한견갑상신경포착증후군은결절종의절제만으로는증상의완전한해소를기대하기어려우며, 수술시결절종에의한주병변이외에포착이다발성으로발생할가능성이있으므로결절종의제거및관절내병변의치료와함께견갑상절흔과견갑하절흔부위에서의신경에대한감압술을함께고려하는것이좋을것으로생각한다.

• Journal of Korean Neurosurgical Society
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• 제67권2호
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• pp.217-226
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• 2024

Objective : The efficacy of sciatic nerve decompression via transgluteal approach for entrapment of the sciatic nerve at the greater sciatic notch, called piriformis syndrome, and factors affecting the surgical outcome were analyzed. Methods : The outcome of pain reduction was analyzed in 81 patients with sciatic nerve entrapment who underwent decompression through a transgluteal approach. The patients were followed up for at least 6 months. The degree of pain reduction was analyzed using a numerical rating scale-11 (NRS-11) score and percent pain relief before and after last follow-up following surgery. Success was defined by at least 50% reduction in pain measured via NRS-11. To assess the degree of subjective satisfaction, a 10-point Likert scale was used. In addition, demographic characteristics, anatomical variations, and variations in surgical technique involving sacrotuberous ligamentectomy were analyzed as factors that affect the surgical outcome. Results : At a follow-up of 17.5±12.5 months, sciatic nerve decompression was successful in 50 of 81 patients (61.7%), and the pain relief rate was 43.9±34.17. Subjective improvement based on a 10-point Likert scale was 4.90±3.43. Among the factors that affect the surgical outcome, only additional division of the sacrotuberous ligament during piriformis muscle resection played a significant role. The success rate was higher in the scarotuberous ligementectomy group (79.4%) than in the non-resection group (42.6%), resulting in statistically significant difference based on average NRS-11 score, percent pain relief, and subjective improvement (p<0.05, independent t-test). Conclusion : Sciatic nerve decompression is effective in pain relief in chronic sciatica due to sciatic nerve entrapment at the greater sciatic notch. Its effect was further enhanced by circumferential dissection of the sciatic nerve based on the compartment formed by the piriformis muscle and the sacrotuberous ligament in the greater sciatic notch.

• The Korean Journal of Pain
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• 제8권1호
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• pp.149-151
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• 1995

Piriformis syndrome is a syndrome of low back and leg radiating pain thought to be due to a chronic contracture of the piriformis muscle that causes irritation of the sciatic nerve. The piriformis muscle is a flat pyramidal muscle, an external rotator and abductor of the hip, originating from the front of the sacrum and inner aspect of the sacroiliac joint, then passes laterally out of the sciatic notch to attach posteriorly to the greater trochanter of the femur, the sciatic nerve passes between the two bellies of the muscle. Mechanical irritation of the sciatic nerve by an inflammatory reaction of the piriformis muscle and its fascia at this pelvic level causes pain to radiate in the dermatomal regions of the nerve roots similar to that disk entrapment. diagnosis of piriformis syndrome is made primary on the basis of history and clinical examination. The incidence is considerably higher in women, with the reported ratio of women to men of 6:1. These patients frequently present with associated symptoms of pelvic pain and/or dyspareunia. Symptoms are usually unilateral but occasionally be bilateral. We had a 42 year-old woman patient with low back and left leg radiating pain and dyspareunia treated by caudal steroid and local anesthetic.

• The Korean Journal of Pain
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• 제8권2호
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• pp.341-346
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• 1995

Piriformis Syndrome is characterized by pain of the low back, groin, perineum, buttock, hip, posterior thigh, leg and foot. Symptoms are aggravated by sitting, prolonged combination of hip flexion, adduction, the medial rotation, or by activity. In addition, patient may complain of painful swelling of the limb and sexual dysfunction-dyspareunia in female, and impotence in male. It currently appears that three specific conditions may contribute to the piriformis syndrome: (a) myofascial pain; (b) nerve and vascular entrapment; (c) dysfunction of the sacroiliac joint. The important keys of diagnosis are history and physical examination. There is no known objective diagnostic method. We described the clinical features of four cases of piriformis syndrome and reviewed foreign literature.