Skip to main content
SpringerLink
Log in

Sciatic Neuropathy: Case Report and Discussion of the Literature on Postoperative Sciatic Neuropathy and Sciatic Nerve Tumors

  • Electrodiagnostic Corner
  • Published:
HSS Journal

Abstract

Sciatic nerve injury and dysfunction is not an uncommon cause of lower extremity symptoms in a musculoskeletal practice. We present the case of a man who presented with lower extremity weakness, pain, and cramps, and was initially diagnosed at an outside institution with bilateral S1 radiculopathies and recommended for spine surgery. He came to us for a second opinion. Electrodiagnostic testing revealed an isolated sciatic neuropathy and the patient was referred for imaging, which showed a sciatic nerve sheath tumor. Review of the literature on sciatic neuropathies shows that there can be many possible etiologies of sciatic nerve dysfunction, but that hip arthroplasty continues to be the leading risk factor. Sciatic nerve tumors are not commonly described in the literature and their definitive management remains unclear.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig 1
Fig 2

Similar content being viewed by others

References

  1. Yuen EC, So YT (1999) Entrapment and other focal neuropathies: sciatic neuropathy. Neurol Clin 17(3):617–631 August

    Article  PubMed  CAS  Google Scholar 

  2. Sunderland S (1951) A classification of peripheral nerve injuries producing loss of function. Brain 74:491–516

    Article  PubMed  CAS  Google Scholar 

  3. Plewnia C, Wallace C et al. (1999) Traumatic sciatic neuropathy: a novel cause, local experience and a review of the literature. J Trauma 47(5):986–999 November

    Article  PubMed  CAS  Google Scholar 

  4. Kim DH, Murovic JA et al. (2004) Management and outcomes in 353 surgically treated sciatic nerve lesions. J Neurosurg 101:8–17 July

    PubMed  Google Scholar 

  5. Yuen EC, Onley RK et al. (1994) Sciatic neuropathy: clinical and prognostic features in 73 patients. Neurology 44(9):1669–1674 September

    PubMed  CAS  Google Scholar 

  6. Fishman LM, Schaefer MP (2003) The piriformis syndrome is underdiagnosed. Muscle Nerve 28(5):646–649 Nov

    Article  PubMed  Google Scholar 

  7. Stewart JD (2003) The piriformis syndrome is overdiagnosed. Muscle Nerve 28(5):644–646 Nov

    Article  PubMed  Google Scholar 

  8. Moore KR, Tsuruda JS, Dailey AT (2001) The value of MR neurography for evaluating extraspinal neuropathic leg pain: a pictorial essay. Am J Neuroradiol 22:786–794 April

    PubMed  CAS  Google Scholar 

  9. Bendszus M, Koltzenburg, M (2001) Visualization of denervated muscle by gadolinium-enhanced MRI. Neurology 57(9):1709–1711 Nov

    PubMed  CAS  Google Scholar 

  10. Van Langenhove M, Pollefliet A, Vanderstraeten G (1989) A retrospective electrodiagnostic evaluation of footdrop in 303 patients. Electromyogr Clin Neurophysiol 29(3):145–152 April

    PubMed  Google Scholar 

  11. Sunderland S (1978) Sciatic, tibial and common peroneal nerve lesions. In Nerves and nerve injuries, 2nd edn. Churchill Livingstone, Edinburgh, pp 967–991

    Google Scholar 

  12. Sunderland S (1953) The relative susceptibility to injury of the medial and lateral popliteal divisions of the sciatic nerve. Br J Surg 41:300–302

    Article  PubMed  CAS  Google Scholar 

  13. Yuen EC, So YT, Onley RK (1995) The electrodiagnostic features of sciatic neuropathy in 100 patients. Muscle Nerve 18(4):414–420 April

    Article  PubMed  CAS  Google Scholar 

  14. Schmalzried TP, Noordin S, Amstutz HC (1997) Update on nerve palsy associated with total hip replacement. Clin Orthop Relat Res 344:188–206

    Article  PubMed  Google Scholar 

  15. Farrell CM, Springer BD, Haidukewych GJ, Morrey BF (2005) Motor nerve palsy following primary total hip arthroplasty. J Bone Jt Surg-Am Vol 87(12):2619–2625 December

    Article  Google Scholar 

  16. Weber ER, Daube JR, Coventry MB (1976) Peripheral neuropathies associated with total hip arthroplasty. J Bone Jt Surg-Am Vol 58(1):66–69 January

    CAS  Google Scholar 

  17. Weale AE, Newman P, Ferguson IT, Bannister GC (1996) Nerve injury after posterior and direct lateral approaches for hip replacement. A clinical and electrophysiological study. J Bone Jt Surg-Br Vol 78(6):899–902 November

    Article  CAS  Google Scholar 

  18. Crawford JR, Van Rensburg L, Marx C (2003) Compression of the sciatic nerve by wear debris following total hip replacement: a report of three cases. J Bone Jt Surg-Br Vol 85(8):1178–1180 November

    Article  CAS  Google Scholar 

  19. Thomas JE, Piepgras DG, Scheithauser B, Onofrio BM, Shives TC (1983) Neurogenic tumors of the sciatic nerve: a clinicopathologic study of 35 cases. Mayo Clin Proc 58(10):640–647 Oct

    PubMed  CAS  Google Scholar 

  20. Benzel EC, Morris DM, Fowler MR (1988) Nerve sheath tumors of the sciatic nerve and sacral plexus. J Surg Oncol 39:8–16

    Article  PubMed  CAS  Google Scholar 

  21. Bader R, Mittelmeier W et al. (2005) Pitfalls in the use of acetabular reinforcement rings in total hip revision. Arch Orthop Trauma Surg 125(8):558–563 October

    Article  PubMed  Google Scholar 

  22. Sosna A, Pokorny D, Jahoda D (2005) Sciatic nerve palsy after total hip replacement. JBJS (Br) 87-B(8):1140–1141, August

    Google Scholar 

  23. Huang JH, Simon SL, Nagpal S, Nelson PT, Zager EL (2004) Management of patients with schwannomatosis: report of six cases and review of the literature. Surg Neurol 62(4):353–361 October

    Article  PubMed  Google Scholar 

  24. Tomaino MM (2002) Complete sciatic nerve palsy after open femur fracture: successful treatment with neurolysis 6 months after injury. Am J Orthop 31(10):585–588 October

    PubMed  Google Scholar 

  25. Kline DG, Kim D, Midha R, Harsh C, Tiel R (1998) Management and results of sciatic nerve injuries: a 24-year experience. J Neurosurg 89(1):13–23 July

    Article  PubMed  CAS  Google Scholar 

  26. Schmalzried TP, Eckardt JJ (1992) Spontaneous gluteal artery rupture resulting in compartment syndrome and sciatic neuropathy. Report of a case in Ehlers–Danlos syndrome. Clin Orthop Relat Res (275):253–257 Feb

  27. Sheth D, Gutmann L, Blumenthal DT, Mullett M, Bodensteiner JB, Gutmann L (1994) Compressive sciatic neuropathy due to uterine abnormality. Muscle Nerve 17(12):1486–1488 Dec

    Article  PubMed  CAS  Google Scholar 

  28. Butt AJ, McCarthy T, Kelly IP, Glynn T, McCoy G (2005) Sciatic nerve palsy secondary to postoperative haematoma in primary total hip replacement. J Bone Jt Surg-Br Vol 87(11):1465–1467 Nov

    Article  CAS  Google Scholar 

  29. Austin MS, Klein GR, Sharkey PF, Hozack WJ, Rothman RH (2004) Late sciatic nerve palsy caused by hematoma after primary total hip arthroplasty. J Arthroplast 19(6):790–792 Sep

    Article  Google Scholar 

  30. Tani JC (1995) Fibrous band compression of the tibial nerve branch of the sciatic nerve. Am J Orthop 24(12):910–912 Dec

    PubMed  CAS  Google Scholar 

  31. Ishida K, Imamaki M, Ishida A, Shimura H, Miyazaki M (2005) A ruptured aneurysm in persistent sciatic artery: a case report. J Vasc Surg 42(3):556–558 Sep

    Article  PubMed  Google Scholar 

  32. Gasecki AP, Ebers GC, Vellet AD, Buchan A (1992) Sciatic neuropathy associated with persistent sciatic artery. Arch Neurol 49(9):967–968 Sep

    PubMed  CAS  Google Scholar 

  33. Hernesman SC, Hoch AZ, Vetter CS, Young CC (2003) Foot drop in a marathon runner from chronic complete hamstring tear. Clin J Sport Med 13(6):365–368 Nov

    Article  PubMed  Google Scholar 

  34. Carmody C, Prietto C (1995) Entrapment of the sciatic nerve as a late sequela of injury to the hamstring muscles. A case report. J Bone Jt Surg-Am Vol 77(7):1100–1102 Jul

    CAS  Google Scholar 

  35. Puranen J, Orava S (1988) The hamstring syndrome. A new diagnosis of gluteal sciatic pain. Am J Sports Med 16(5):517–521 Sep–Oct

    Article  PubMed  CAS  Google Scholar 

  36. Poppi M, Giuliani G, Gambari PI, Acciarri N, Gaist G, Calbucci F (1989) A hazard of craniotomy in the sitting position: the posterior compartment syndrome of the thigh. Case report. J Neurosurg 71(4):618–619 Oct

    PubMed  CAS  Google Scholar 

  37. Gozal Y, Pomeranz S (1994) Sciatic nerve palsy as a complication after acoustic neurinoma resection in the sitting position. J Neurosurg Anesthesiol 6(1):40–42 Jan

    PubMed  CAS  Google Scholar 

  38. Dimachkie MM, Ohanian S, Groves MD, Vriesendorp FJ (2000) Peripheral nerve injury after brief lithotomy for transurethral collagen injection. Urology 56(4):669 October

    Article  PubMed  CAS  Google Scholar 

  39. Romfh JH, Currier RD (1983) Sciatic neuropathy induced by the lithotomy position. Arch Neurol 40(2):127 Feb

    PubMed  CAS  Google Scholar 

  40. Roy S, Levine AB, Herbison GJ, Jacobs SR (2002) Intraoperative positioning during cesarean as a cause of sciatic neuropathy. Obstet Gynecol 99(4):652–653 Apr

    Article  PubMed  Google Scholar 

  41. McManis PG (1994) Sciatic nerve lesions during cardiac surgery. Neurology 44(4):684–687 Apr

    PubMed  CAS  Google Scholar 

  42. Dakwar E, Teja S, Alleyne CH Jr (2004) Sciatic neurolymphomatosis. Neurology 63(9):1751 Nov 9

    PubMed  Google Scholar 

  43. Maini A, Tripathi M, Shekar NC, Malhotra A (2003) Sciatic schwannoma of the thigh detected on bone scan: a case report. Clin Imaging 27(3):191–193 May–Jun

    Article  PubMed  Google Scholar 

  44. Agarwal M, Shatma MC, Deol P, Mehta VS, Sarkar C (2002) Epithelioid sarcoma of the sciatic nerve perineural sheath: a mimic of nerve sheath tumor. Pathol Oncol Res 8(2):148–150

    Article  PubMed  CAS  Google Scholar 

  45. Yamamoto T, Maruyama S, Mizuno K (2001) Schwannomatosis of the sciatic nerve. Skelet Radiol 30(2):109–113 Feb

    Article  CAS  Google Scholar 

  46. Botwin KP, Shah CP, Zak PJ (2001) Sciatic neuropathy secondary to infiltrating intermuscular lipoma of the thigh. Am J Phys Med Rehabil 80(10):754–758 October

    Article  PubMed  CAS  Google Scholar 

  47. Isiklar ZU, Lindsey RW, Tullos HS (1997) Sciatic neuropathy secondary to intrapelvic migration of an acetabular cup. A case report. J Bone Jt Surg-Am Vol 79(9):1395–1397 Sep

    CAS  Google Scholar 

  48. Asnis SE, Hanley S, Shelton PD (1985) Sciatic neuropathy secondary to migration of trochanteric wire following total hip arthroplasty. Clin Orthop Relat Res (196):226–228 Jun

  49. Oleksak M, Edge AJ (1992) Compression of the sciatic nerve by methylmethacrylate cement after total hip replacement. J Bone Jt Surg-Br Vol 74(5):729–730 Sep

    CAS  Google Scholar 

  50. Brennan MF (2000) Soft tissue sarcoma involving the sciatic nerve. Br J Surg 87(8):983 Aug

    Article  PubMed  CAS  Google Scholar 

  51. Melendez M, Brandt K, Evans GR (2001) Sciatic nerve reconstruction: limb preservation after sarcoma resection. Ann Plast Surg 46(4):375–381 Apr

    Article  PubMed  CAS  Google Scholar 

  52. Dailey AT, Rondina MT, Townsend JJ, Shrieve DC, Baringer JR, Moore KR (2004) Sciatic nerve sarcoidosis: utility of magnetic resonance peripheral nerve imaging and treatment with radiation therapy. J Neurosurg 100(5):956–959 May

    PubMed  Google Scholar 

  53. Misdraji J, Ino Y, Louis DN, Rosenberg AE, Chiocca EA, Harris NL (2000) Primary lymphoma of peripheral nerve: report of four cases. Am J Surg Pathol 24(9):1257–1265 Sep

    Article  PubMed  CAS  Google Scholar 

  54. Kanamori M, Matsui H, Yudoh K (1995) Solitary T-cell lymphoma of the sciatic nerve: case report. Neurosurgery 36(6):1203–1205 Jun

    Article  PubMed  CAS  Google Scholar 

  55. Quinones-Hinojosa A, Friedlander RM, Boyer PJ, Batchelor TT, Chiocca EA (2000) Solitary sciatic nerve lymphoma as an initial manifestation of diffuse neurolymphomatosis. Case report and review of the literature. J Neurosurg 92(1):165–169 Jan

    Article  PubMed  CAS  Google Scholar 

  56. Roncaroli F, Poppi M, Riccioni L, Frank F (1997) Primary non-Hodgkin's lymphoma of the sciatic nerve followed by localization in the central nervous system: case report and review of the literature. Neurosurgery 40(3):618–621; discussion 621–622 Mar

    Article  PubMed  CAS  Google Scholar 

  57. Johanson NA, Pellicci PM, Tsairis P, Salvati EA (1983) Nerve injury in total hip arthroplasty. Clin Orthop Relat Res (179):214–222 Oct

Download references

Author information

Authors and Affiliations

  1. Electrodiagnostic Services, Department of Physiatry, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Joseph Feinberg & Shikha Sethi

Authors
  1. Joseph Feinberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shikha Sethi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph Feinberg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Feinberg, J., Sethi, S. Sciatic Neuropathy: Case Report and Discussion of the Literature on Postoperative Sciatic Neuropathy and Sciatic Nerve Tumors. HSS Jrnl 2, 181–187 (2006). https://doi.org/10.1007/s11420-006-9018-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11420-006-9018-z

Key words

Search

Navigation