Results of Neurolysis for the Treatment of Neuropathic Pain in Patients with Sciatic Nerve Injury. Case Report

  • Mariano García Bistolfi Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-5444-6927
  • Gonzalo Magno Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0001-9573-1970
  • Pilar Saralegui Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-7790-6092
  • Gerardo L. Gallucci Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-0612-320X
  • Pablo De Carli Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-9474-8129
  • Agustín Donndorff Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-6384-4820
  • Ignacio Rellán Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0003-4045-339X
  • Jorge G. Boretto Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0001-7701-3852
Keywords: Sciatic neurolysis, neuropathic pain, SF-36 questionnaire, sciatic nerve injury

Abstract

Introduction: Sciatic nerve injury may cause paresthesias and hypoesthesias, severe neuropathic pain, and paralysis. Neurolysis can improve function, pain, and quality of life for these patients. The objective of this paper is to evaluate the clinical-functional outcomes of a series of patients with neuropathic pain due to sciatic nerve injury that was refractory to conservative treatment in whom neurolysis was performed. Materials and Methods: A retrospective case series of patients operated on for neurolysis of the greater sciatic nerve between March 2009 and June 2018 was analyzed. Preoperative and postoperative pain were evaluated using the visual analog scale (VAS) and the Likert scale. The type of postoperative pain was evaluated using the DN4 questionnaire, and the health-related quality of life was measured with the SF-36 questionnaire. Results: Eight patients were included. All patients evolved with a notable improvement in pain, with an average of 3 and 1.88 points on the VAS and Likert scales, respectively. The mean follow-up was 32 months (range 14–66). The DN4 questionnaire showed an average of 3.75 points (range 2–7). According to the SF-36, “Physical Health” was the variable with the worst results, with an average of 30.15. Conclusions: Sciatic nerve neurolysis in patients with neuropathic pain due to sciatic nerve injury and poor response to conservative treatment may improve pain and quality of life.

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Author Biographies

Mariano García Bistolfi, Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Gonzalo Magno, Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Pilar Saralegui, Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Gerardo L. Gallucci, Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Pablo De Carli, Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Agustín Donndorff, Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Ignacio Rellán, Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Jorge G. Boretto, Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hand and Upper Limb Surgery Sector, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

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Published
2023-04-24
How to Cite
García Bistolfi, M., Magno, G., Saralegui, P., Gallucci, G. L., De Carli, P., Donndorff, A., Rellán, I., & Boretto, J. G. (2023). Results of Neurolysis for the Treatment of Neuropathic Pain in Patients with Sciatic Nerve Injury. Case Report. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(2), 156-163. https://doi.org/10.15417/issn.1852-7434.2023.88.2.1380
Section
Clinical Research