Skip to main content
SpringerLink
Log in

Deep Gluteal Space

  • Reference work entry
  • First Online:
Hip Arthroscopy and Hip Joint Preservation Surgery

Abstract

Deep gluteal syndrome is characterized by nondiscogenic, extrapelvic sciatic nerve compression presenting with symptoms of pain and dysesthesias in the buttock area, hip, or posterior thigh and/or as radicular pain. The piriformis muscle and tendon are the most common source of extrapelvic sciatic nerve entrapment. However, a number of structures can entrap the sciatic nerve in the deep gluteal space, including bone structures, fibrous scar bands, and muscular structures other than the piriformis. The main differential diagnoses are intra-articular hip pathologies, spine issues, intrapelvic abnormalities, ischiofemoral impingement, hamstring’s origin tendinopathy, and pudendal nerve entrapment. A comprehensive history and physical examination is crucial for the diagnosis of deep gluteal syndrome . Guided injections and magnetic resonance imaging are useful complementary diagnostic tools. The nonoperative treatment of deep gluteal syndrome is successful in most patients. Endoscopic sciatic nerve decompression may be indicated in cases of failure of the conservative treatment.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 599.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 799.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. McCrory P, Bell S. Nerve entrapment syndromes as a cause of pain in the hip, groin and buttock. Sports Med. 1999;27:261–74.

    CAS  PubMed  Google Scholar 

  2. Martin HD, Shears SA, Johnson JC, Smathers AM, Palmer IJ. The endoscopic treatment of sciatic nerve entrapment/deep gluteal syndrome. Arthroscopy. 2011;27:172–81.

    PubMed  Google Scholar 

  3. Vandertop WP, Bosma NJ. The piriformis syndrome. A case report. J Bone Joint Surg Am. 1991;73:1095–7.

    CAS  PubMed  Google Scholar 

  4. Puranen J, Orava S. The hamstring syndrome. A new diagnosis of gluteal sciatic pain. Am J Sports Med. 1988;16:517–21.

    CAS  PubMed  Google Scholar 

  5. Young IJ, van Riet RP, Bell SN. Surgical release for proximal hamstring syndrome. Am J Sports Med. 2008;36:2372–8.

    PubMed  Google Scholar 

  6. Cox JM, Bakkum BW. Possible generators of retrotrochanteric gluteal and thigh pain: the gemelli-obturator internus complex. J Manipulative Physiol Ther. 2005;28:534–8.

    PubMed  Google Scholar 

  7. Meknas K, Kartus J, Letto JI, Christensen A, Johansen O. Surgical release of the internal obturator tendon for the treatment of retro-trochanteric pain syndrome: a prospective randomized study, with long-term follow-up. Knee Surg Sports Traumatol Arthrosc. 2009;17:1249–56.

    PubMed  Google Scholar 

  8. Miller A, Stedman GH, Beisaw NE, Gross PT. Sciatica caused by an avulsion fracture of the ischial tuberosity. A case report. J Bone Joint Surg Am. 1987;69:143–5.

    CAS  PubMed  Google Scholar 

  9. Labropoulos N, Tassiopoulos AK, Gasparis AP, et al. Veins along the course of the sciatic nerve. J Vasc Surg. 2009;49(3):690–6.

    PubMed  Google Scholar 

  10. Papadopoulos SM, McGillicuddy JE, Albers JW. Unusual cause of ‘piriformis muscle syndrome’. Arch Neurol. 1990;47:1144–6.

    CAS  PubMed  Google Scholar 

  11. Beauchesne RP, Schutzer SF. Myositis ossificans of the piriformis muscle: an unusual cause of piriformis syndrome. A case report. J Bone Joint Surg Am. 1997;79:906–10.

    CAS  PubMed  Google Scholar 

  12. Chen WS. Sciatica due to piriformis pyomyositis. Report of a case. J Bone Joint Surg Am. 1992;74:1546–8.

    CAS  PubMed  Google Scholar 

  13. Possover M. Laparoscopic management of endopelvic etiologies of pudendal pain in 134 consecutive patients. J Urol. 2009;181:1732–6.

    PubMed  Google Scholar 

  14. Loukas M, Louis Jr RG, Hallner B, Gupta AA, White D. Anatomical and surgical considerations of the sacrotuberous ligament and its relevance in pudendal nerve entrapment syndrome. Surg Radiol Anat. 2006;28:163–9.

    PubMed  Google Scholar 

  15. Meknas K, Christensen A, Johansen O. The internal obturator muscle may cause sciatic pain. Pain. 2003;104:375–80.

    PubMed  Google Scholar 

  16. Solomon LB, Lee YC, Callary SA, Beck M, Howie DW. Anatomy of piriformis, obturator internus and obturator externus: implications for the posterior surgical approach to the hip. J Bone Joint Surg Br. 2010;92:1317–24.

    CAS  PubMed  Google Scholar 

  17. Standring S. Grays anatomy the anatomical basis of clinical practice. London: Churchill Livingstone Elsevier; 2008.

    Google Scholar 

  18. Miller SL, Gill J, Webb GR. The proximal origin of the hamstrings and surrounding anatomy encountered during repair. A cadaveric study. J Bone Joint Surg Am. 2007;89:44–8.

    PubMed  Google Scholar 

  19. Filler AG. Diagnosis and treatment of pudendal nerve entrapment syndrome subtypes: imaging, injections, and minimal access surgery. Neurosurg Focus. 2009;26:E9.

    PubMed  Google Scholar 

  20. Moore K, Dalley A. Essential clinical anatomy. Philadelphia: Lippincott Williams and Wilkins; 1999.

    Google Scholar 

  21. Windhofer C, Brenner E, Moriggl B, Papp C. Relationship between the descending branch of the inferior gluteal artery and the posterior femoral cutaneous nerve applicable to flap surgery. Surg Radiol Anat. 2002;24:253–7.

    CAS  PubMed  Google Scholar 

  22. Kalhor M, Beck M, Huff TW, Ganz R. Capsular and pericapsular contributions to acetabular and femoral head perfusion. J Bone Joint Surg Am. 2009;91:409–18.

    PubMed  Google Scholar 

  23. Gautier E, Ganz K, Krugel N, Gill T, Ganz R. Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg Br. 2000;82:679–83.

    CAS  PubMed  Google Scholar 

  24. Sunderland S, Hughes ES. Metrical and non-metrical features of the muscular branches of the sciatic nerve and its medial and lateral popliteal divisions. J Comp Neurol. 1946;85:205–22.

    CAS  PubMed  Google Scholar 

  25. Sunderland S, Ray LJ. The intraneural topography of the sciatic nerve and its popliteal divisions in man. Brain. 1948;71:242–73.

    CAS  PubMed  Google Scholar 

  26. Seidel PM, Seidel GK, Gans BM, Dijkers M. Precise localization of the motor nerve branches to the hamstring muscles: an aid to the conduct of neurolytic procedures. Arch Phys Med Rehabil. 1996;77:1157–60.

    CAS  PubMed  Google Scholar 

  27. Moayeri N, Groen GJ. Differences in quantitative architecture of sciatic nerve may explain differences in potential vulnerability to nerve injury, onset time, and minimum effective anesthetic volume. Anesthesiology. 2009;111:1128–34.

    PubMed  Google Scholar 

  28. Sladjana UZ, Ivan JD, Bratislav SD. Microanatomical structure of the human sciatic nerve. Surg Radiol Anat. 2008;30:619–26.

    PubMed  Google Scholar 

  29. Georgakis E, Soames R. Arterial supply to the sciatic nerve in the gluteal region. Clin Anat. 2008;21:62–5.

    PubMed  Google Scholar 

  30. Karmanska W, Mikusek J, Karmanski A. Nutrient arteries of the human sciatic nerve. Folia Morphol (Warsz). 1993;52:209–15.

    CAS  Google Scholar 

  31. Ugrenovic SZ, Jovanovic ID, Vasovic LP, Stefanovic BD. Extraneural arterial blood vessels of human fetal sciatic nerve. Cells Tissues Organs. 2007;186:147–53.

    PubMed  Google Scholar 

  32. Del Pinal F, Taylor GI. The venous drainage of nerves; anatomical study and clinical implications. Br J Plast Surg. 1990;43:511–20.

    PubMed  Google Scholar 

  33. Testut L, Latarjet A. Traite d’anatomie humaine. Paris: G. Doin & Cie; 1949.

    Google Scholar 

  34. Possover M, Schneider T, Henle KP. Laparoscopic therapy for endometriosis and vascular entrapment of sacral plexus. Fertil Steril. 2011;95:756–8.

    PubMed  Google Scholar 

  35. Beaton L, Anson B. The sciatic nerve and the piriformis muscle: their interrelation and possible cause of coccygodynia. J Bone Joint Surg Am. 1938;20:686–8.

    Google Scholar 

  36. Smoll NR. Variations of the piriformis and sciatic nerve with clinical consequence: a review. Clin Anat. 2010;23:8–17.

    PubMed  Google Scholar 

  37. Coppieters MW, Alshami AM, Babri AS, Souvlis T, Kippers V, Hodges PW. Strain and excursion of the sciatic, tibial, and plantar nerves during a modified straight leg raising test. J Orthop Res. 2006;24:1883–9.

    PubMed  Google Scholar 

  38. Fleming P, Lenehan B, O’Rourke S, McHugh P, Kaar K, McCabe JP. Strain on the human sciatic nerve in vivo during movement of the hip and knee. J Bone Joint Surg Br. 2003;85:363–5.

    CAS  PubMed  Google Scholar 

  39. Wall EJ, Massie JB, Kwan MK, Rydevik BL, Myers RR, Garfin SR. Experimental stretch neuropathy. Changes in nerve conduction under tension. J Bone Joint Surg Br. 1992;74:126–9.

    CAS  PubMed  Google Scholar 

  40. Guvencer M, Akyer P, Iyem C, Tetik S, Naderi S. Anatomic considerations and the relationship between the piriformis muscle and the sciatic nerve. Surg Radiol Anat. 2008;30:467–74.

    PubMed  Google Scholar 

  41. Yeoman W. The relation of arthritis of the sacro-iliac joint to sciatica, with an analysis of 100 cases. Lancet. 1928;2:1119–22.

    Google Scholar 

  42. Robinson DR. Pyriformis syndrome in relation to sciatic pain. Am J Surg. 1947;73:355–8.

    CAS  PubMed  Google Scholar 

  43. Adams JA. The pyriformis syndrome – report of four cases and review of the literature. S Afr J Surg. 1980;18:13–8.

    CAS  PubMed  Google Scholar 

  44. Benson ER, Schutzer SF. Posttraumatic piriformis syndrome: diagnosis and results of operative treatment. J Bone Joint Surg Am. 1999;81:941–9.

    CAS  PubMed  Google Scholar 

  45. Dezawa A, Kusano S, Miki H. Arthroscopic release of the piriformis muscle under local anesthesia for piriformis syndrome. Arthroscopy. 2003;19:554–7.

    PubMed  Google Scholar 

  46. Filler AG, Haynes J, Jordan SE, Prager J, Villablanca JP, Farahani K, McBride DQ, Tsuruda JS, Morisoli B, Batzdorf U, Johnson JP. Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. J Neurosurg Spine. 2005;2:99–115.

    PubMed  Google Scholar 

  47. Hughes SS, Goldstein MN, Hicks DG, Pellegrini Jr VD. Extrapelvic compression of the sciatic nerve. An unusual cause of pain about the hip: report of five cases. J Bone Joint Surg Am. 1992;74:1553–9.

    CAS  PubMed  Google Scholar 

  48. Mayrand N, Fortin J, Descarreaux M, Normand MC. Diagnosis and management of posttraumatic piriformis syndrome: a case study. J Manipulative Physiol Ther. 2006;29:486–91.

    PubMed  Google Scholar 

  49. Sayson SC, Ducey JP, Maybrey JB, Wesley RL, Vermilion D. Sciatic entrapment neuropathy associated with an anomalous piriformis muscle. Pain. 1994;59:149–52.

    CAS  PubMed  Google Scholar 

  50. Bano A, Karantanas A, Pasku D, Datseris G, Tzanakakis G, Katonis P. Persistent sciatica induced by quadratus femoris muscle tear and treated by surgical decompression: a case report. J Med Case Rep. 2010;4:236.

    PubMed Central  PubMed  Google Scholar 

  51. Brown JA, Braun MA, Namey TC. Pyriformis syndrome in a 10-year-old boy as a complication of operation with the patient in the sitting position. Neurosurgery. 1988;23:117–9.

    CAS  PubMed  Google Scholar 

  52. Issack PS, Kreshak J, Klinger CE, Toro JB, Buly RL, Helfet DL. Sciatic nerve release following fracture or reconstructive surgery of the acetabulum. Surgical technique. J Bone Joint Surg Am. 2008;90(Suppl 2 Pt 2):227–37.

    PubMed  Google Scholar 

  53. Uchio Y, Nishikawa U, Ochi M, Shu N, Takata K. Bilateral piriformis syndrome after total hip arthroplasty. Arch Orthop Trauma Surg. 1998;117:177–9.

    CAS  PubMed  Google Scholar 

  54. Filler AG. Piriformis and related entrapment syndromes: diagnosis & management. Neurosurg Clin N Am. 2008;19:609–22, vii.

    PubMed  Google Scholar 

  55. Chakravarthy J, Ramisetty N, Pimpalnerkar A, Mohtadi N. Surgical repair of complete proximal hamstring tendon ruptures in water skiers and bull riders: a report of four cases and review of the literature. Br J Sports Med. 2005;39:569–72.

    CAS  PubMed Central  PubMed  Google Scholar 

  56. Orava S. Hamstring syndrome. Op Tech Sports Med. 1997;5:143–9.

    Google Scholar 

  57. Wood DG, Packham I, Trikha SP, Linklater J. Avulsion of the proximal hamstring origin. J Bone Joint Surg Am. 2008;90:2365–74.

    PubMed  Google Scholar 

  58. Martin H. Clinical examination and imaging of the hip. In: Byrd J, Guanche C, editors. AANA advanced arthroscopy: the hip. Philadelphia: Saunders; 2010.

    Google Scholar 

  59. Martin HD, Kelly BT, Leunig M, Philippon MJ, Clohisy JC, Martin RL, Sekiya JK, Pietrobon R, Mohtadi NG, Sampson TG, Safran MR. The pattern and technique in the clinical evaluation of the adult hip: the common physical examination tests of hip specialists. Arthroscopy. 2010;26:161–72.

    PubMed  Google Scholar 

  60. Papadopoulos EC, Khan SN. Piriformis syndrome and low back pain: a new classification and review of the literature. Orthop Clin North Am. 2004;35:65–71.

    PubMed  Google Scholar 

  61. Martin HD, Kivlan BR, Palmer IJ, Martin RL, Hatem M. Diagnostic accuracy of clinical tests for sciatic nerve entrapment in the gluteal region. Knee Surg Sports Traumatol Arthrosc. 2014;22:882–888.

    Google Scholar 

  62. Migliorini S, Merlo M. The hamstring syndrome in endurance athletes. Br J Sports Med. 2011;45:363.

    Google Scholar 

  63. Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Rigaud J. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn. 2008;27:306–10.

    PubMed  Google Scholar 

  64. Fishman LM, Wilkins AN. Piriformis syndrome: electrophysiology vs. anatomical assumption. In: Fishman LM, Wilkins AN, editors. Functional electromyography. New York: Springer; 2011.

    Google Scholar 

  65. Jawish RM, Assoum HA, Khamis CF. Anatomical, clinical and electrical observations in piriformis syndrome. J Orthop Surg Res. 2010;5:3.

    PubMed Central  PubMed  Google Scholar 

  66. Katirji B. Electrodiagnostic approach to the patient with suspected mononeuropathy of the lower extremity. Neurol Clin. 2002;20:479–501, vii.

    PubMed  Google Scholar 

  67. Petchprapa CN, Rosenberg ZS, Sconfienza LM, Cavalcanti CF, Vieira RL, Zember JS. MR imaging of entrapment neuropathies of the lower extremity. Part 1. The pelvis and hip. Radiographics. 2010;30:983–1000.

    PubMed  Google Scholar 

  68. Chappell KE, Robson MD, Stonebridge-Foster A, Glover A, Allsop JM, Williams AD, Herlihy AH, Moss J, Gishen P, Bydder GM. Magic angle effects in MR neurography. AJNR Am J Neuroradiol. 2004;25:431–40.

    PubMed  Google Scholar 

  69. Kim SJ, Hong SH, Jun WS, Choi JY, Myung JS, Jacobson JA, Lee JW, Choi JA, Kang HS. MR imaging mapping of skeletal muscle denervation in entrapment and compressive neuropathies. Radiographics. 2011;31:319–32.

    PubMed  Google Scholar 

  70. Barton PM. Piriformis syndrome: a rational approach to management. Pain. 1991;47:345–52.

    CAS  PubMed  Google Scholar 

  71. Benzon HT, Katz JA, Benzon HA, Iqbal MS. Piriformis syndrome: anatomic considerations, a new injection technique, and a review of the literature. Anesthesiology. 2003;98:1442–8.

    PubMed  Google Scholar 

  72. Pace JB, Nagle D. Piriform syndrome. West J Med. 1976;124:435–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  73. Porta M. A comparative trial of botulinum toxin type A and methylprednisolone for the treatment of myofascial pain syndrome and pain from chronic muscle spasm. Pain. 2000;85:101–5.

    CAS  PubMed  Google Scholar 

  74. Hanania M, Kitain E. Perisciatic injection of steroid for the treatment of sciatica due to piriformis syndrome. Reg Anesth Pain Med. 1998;23:223–8.

    CAS  PubMed  Google Scholar 

  75. Torriani M, Souto SC, Thomas BJ, Ouellette H, Bredella MA. Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol. 2009;193:186–90.

    PubMed  Google Scholar 

  76. Johnson KA. Impingement of the lesser trochanter on the ischial ramus after total hip arthroplasty. Report of three cases. J Bone Joint Surg Am. 1977;59:268–9.

    CAS  PubMed  Google Scholar 

  77. Kassarjian A. Signal abnormalities in the quadratus femoris muscle: tear or impingement? Am J Roentgenol. 2008;190:W380–1.

    Google Scholar 

  78. Patti JW, Ouellette H, Bredella MA, Torriani M. Impingement of lesser trochanter on ischium as a potential cause for hip pain. Skeletal Radiol. 2008;37:939–41.

    PubMed  Google Scholar 

  79. Ali AM, Whitwell D, Ostlere SJ. Case report: imaging and surgical treatment of a snapping hip due to ischiofemoral impingement. Skeletal Radiol. 2011;40:653–6.

    PubMed  Google Scholar 

  80. Truong W, Murnaghan L, Hopyan S, Kelley S. Ischioplasty for femoroischial impingement. J Bone Joint Surg Am Case Connect. 2012;2:2–6.

    Google Scholar 

  81. Martin HD, Palmer IJ, Hatem M. Diagnosis and 2-year outcomes of endoscopic treatment for ischiofemoral impingement. Arthroscopy 2014. (Accepted in production).

    Google Scholar 

  82. Scillia A, Choo A, Milman E, McInerney V, Festa A. Snapping of the proximal hamstring origin: a rare cause of coxa saltans: a case report. J Bone Joint Surg Am. 2011;93:e1251–3.

    PubMed  Google Scholar 

  83. Lempainen L, Sarimo J, Mattila K, Vaittinen S, Orava S. Proximal hamstring tendinopathy: results of surgical management and histopathologic findings. Am J Sports Med. 2009;37:727–34.

    PubMed  Google Scholar 

  84. Kim SM, Shin MJ, Kim KS, Ahn JM, Cho KH, Chang JS, Lee SH, Chhem RK. Imaging features of ischial bursitis with an emphasis on ultrasonography. Skeletal Radiol. 2002;31:631–6.

    CAS  PubMed  Google Scholar 

  85. Popeney C, Ansell V, Renney K. Pudendal entrapment as an etiology of chronic perineal pain: diagnosis and treatment. Neurourol Urodyn. 2007;26:820–7.

    PubMed  Google Scholar 

  86. Hough DM, Wittenberg KH, Pawlina W, Maus TP, King BF, Vrtiska TJ, Farrell MA, Antolak Jr SJ. Chronic perineal pain caused by pudendal nerve entrapment: anatomy and CT-guided perineural injection technique. AJR Am J Roentgenol. 2003;181:561–7.

    PubMed  Google Scholar 

  87. Vancaillie T, Eggermont J, Armstrong G, Jarvis S, Liu J, Beg N. Response to pudendal nerve block in women with pudendal neuralgia. Pain Med. 2012;13:596–603.

    PubMed  Google Scholar 

  88. Hibner M, Desai N, Robertson LJ, Nour M. Pudendal neuralgia. J Minim Invasive Gynecol. 2010;17:148–53.

    PubMed  Google Scholar 

  89. Robert R, Labat JJ, Bensignor M, Glemain P, Deschamps C, Raoul S, Hamel O. Decompression and transposition of the pudendal nerve in pudendal neuralgia: a randomized controlled trial and long-term evaluation. Eur Urol. 2005;47:403–8.

    PubMed  Google Scholar 

  90. Vilos GA, Vilos AW, Haebe JJ. Laparoscopic findings, management, histopathology, and outcome of 25 women with cyclic leg pain. J Am Assoc Gynecol Laparosc. 2002;9:145–51.

    PubMed  Google Scholar 

  91. Parsons FG, Keith A. Sixth annual report of the committee of collective investigation of the anatomical society of Great Britain and Ireland, 1895–96. J Anat Physiol. 1896;31(Pt 1):31–44.

    CAS  PubMed Central  PubMed  Google Scholar 

  92. Bardeen K. A statistical study of the variations in the formation and position of the lumbosacral plexus in man. Anat Anz. 1901;9:209–38.

    Google Scholar 

  93. Trotter M. The relation of the sciatic nerve to the piriformis muscle in American Whites and Negroes. Anat Rec. 1932;52:321–3.

    Google Scholar 

  94. Beaton L, Anson B. The relation of the sciatic nerve and of its subdivisions to the piriformis muscle. Anat Rec. 1937;70:1–5.

    Google Scholar 

  95. Ming-Tzu P. The relation of the sciatic nerve to the piriformis muscle in the Chinese. Am J Phys Anthropol. 1941;28:375.

    Google Scholar 

  96. Misra B. The relations of the sciatic nerve to the piriformis in Indian cadavers. J Anat Soc India. 1954;3:28–33.

    Google Scholar 

  97. Anson B, McVay C. Surgical anatomy. Philadelphia: W.B. Saunders; 1971.

    Google Scholar 

  98. Nizankowski C, Slociak J, Szybejko J. Variations in the anatomy of the sciatic nerve in man. Folia Morphol (Warsz). 1972;31(4):507–13.

    CAS  Google Scholar 

  99. Lee CS, Tsai TL. The relation of the sciatic nerve to the piriformis muscle. Taiwan Yi Xue Hui Za Zhi. 1974;73(2):75–80.

    CAS  PubMed  Google Scholar 

  100. Pecina M. Contribution to the etiological explanation of the piriformis syndrome. Acta Anat (Basel). 1979;105(2):181–7.

    CAS  Google Scholar 

  101. Chiba S. Multiple positional relationships of nerves arising from the sacral plexus to the piriformis muscle in humans. Kaibogaku Zasshi. 1992;67(6):691–724.

    CAS  PubMed  Google Scholar 

  102. Chiba S, Ishibashi Y, Kasai T. Perforation of dorsal branches of the sacral nerve plexus through the piriformis muscle and its relation to changes of segmental arrangements of the vertebral column and others. Kaibogaku Zasshi. 1994;69(3):281–305.

    CAS  PubMed  Google Scholar 

  103. Pokorny D, Sosna A, Veigl P, et al. Anatomic variability of the relation of pelvitrochanteric muscles and sciatic nerve. Acta Chir Orthop Traumatol Cech. 1998;65(6):336–9.

    CAS  PubMed  Google Scholar 

  104. Fishman LM, Dombi GW, Michaelsen C, et al. Piriformis syndrome: diagnosis, treatment, and outcome – a 10-year study. Arch Phys Med Rehabil. 2002;83(3):295–301.

    PubMed  Google Scholar 

  105. Agur A, Dalley A. Grant’s atlas of anatomy. Baltimore: Lippincott Williams & Wilkins; 2005.

    Google Scholar 

  106. Ugrenovic S, Jovanovic I, Krstic V, et al. The level of the sciatic nerve division and its relations to the piriform muscle. Vojnosanit Pregl. 2005;62(1):45–9.

    PubMed  Google Scholar 

  107. Pokorny D, Jahoda D, Veigl D, et al. Topographic variations of the relationship of the sciatic nerve and the piriformis muscle and its relevance to palsy after total hip arthroplasty. Surg Radiol Anat. 2006;28(1):88–91.

    PubMed  Google Scholar 

  108. Guvencer M, Iyem C, Akyer P, et al. Variations in the high division of the sciatic nerve and relationship between the sciatic nerve and the piriformis. Turk Neurosurg. 2009;19(2):139–44.

    PubMed  Google Scholar 

  109. Labropoulos N, Tassiopoulos AK, Gasparis AP, et al. Veins along the course of the sciatic nerve. J Vasc Surg. 2009;49(3):690–6.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Baylor University Medical Center, Hip Preservation Center, 411 N Washington Ave, Suite 7300, 75246, Dallas, TX, USA

    Hal D. Martin, Ian J. Palmer & Munif A. Hatem

Authors
  1. Hal D. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ian J. Palmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Munif A. Hatem
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hal D. Martin .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Shane J. Nho

  2. Department of Orthopaedic Surgery, Schulthess Klinik, Zurich, Switzerland

    Michael Leunig

  3. Minnesota Orthopedic Sports Medicine Institute, Twin Cities Orthopedics - Edina, Edina, Minnesota, USA

    Christopher M. Larson

  4. Department of Orthopaedics, University of Michigan, Ann Arbor, Michigan, USA

    Asheesh Bedi

  5. Sports Medicine and Shoulder Service and Center for Hip Preservation Surgery, Hospital for Special Surgery, New York, New York, USA

    Bryan T. Kelly

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this entry

Cite this entry

Martin, H.D., Palmer, I.J., Hatem, M.A. (2015). Deep Gluteal Space. In: Nho, S., Leunig, M., Larson, C., Bedi, A., Kelly, B. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6965-0_75

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-6965-0_75

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6964-3

  • Online ISBN: 978-1-4614-6965-0

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation