Management and outcomes in 353 surgically treated sciatic nerve lesions

• DOI: 10.3171/jns.2004.101.1.0008
• Publication Date: 2009-05-13T18:00:33Z
• Authors: Daniel H. Kim; Judith A. Murovic; Robert Tiel; David G. Kline
• Keywords: Adult; Time Factors; Trauma Severity Indices; Adolescent; Recovery of Function; Middle Aged; Neurosurgical Procedures; Nerve Regeneration; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Thigh; Practice Guidelines as Topic; Buttocks; Humans; Sciatic Neuropathy; Child; Aged; Retrospective Studies

This is a retrospective analysis of 353 surgically treated sciatic nerve lesions in which injury mechanisms, location, time to surgical repair, techniques, and functional outcomes are reported. Results presented provide guidelines for management these injuries.One hundred seventy-five patients with buttock-level 178 thigh-level were at the Louisiana State University Health Sciences Center between 1968 1999. Buttock-level mechanisms included injection 64 patients, hip fracture/dislocation 26, contusion 22, compression 19, gunshot wound (GSW) 17, arthroplasty 15, laceration 12; thigh level, GSW was cause 62 femoral fracture 34, 32, 28, 12, iatrogenic 10. Patients divisions positive intraoperative action potentials (NAPs) found underwent neurolysis attained least Grade 3 108 (87%) 124 91 (96%) 95 buttock- tibial divisions, respectively, compared 84 (71%) 119 75 (79%) 95, peroneal divisions. For suture recovery occurred eight (73%) 11 27 (93%) 29 division injuries, three (30%) 10 20 (69%) lesions. graft good 21 (62%) 34 43 (80%) 54 even proximal repairs requiring long grafts, only nine (24%) 37 22 (45%) 49 lesions, respectively.Surgical exploration after NAP readings, or repair sutures grafts negative results worthwhile selected cases.