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deep gluteal space

Gregory L Cvetanovich, Bryan M Saltzman, Gift Ukwuani, Rachel M Frank, Nikhil N Verma, Charles A Bush-Joseph, Shane J Nho
PURPOSE: To define the anatomy of the pudendal nerve in relationship to the proximal hamstring and other nearby neurological structures during proximal hamstring repair. METHODS: Six fresh-frozen human cadaveric hemi-pelvises from male patients ages 64.0 ± 4.1 years were dissected in prone position with hips in 10° flexion to identify the relationship of proximal hamstring origin to surrounding neurologic structures including the pudendal nerve, sciatic nerve, and posterior femoral cutaneous nerve...
March 29, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Yong Zhao, Libo You, Wei Lian, Dexin Zou, Shengjie Dong, Tao Sun, Shudong Zhang, Dan Wang, Jingning Li, Wenliang Li, Yuchi Zhao
BACKGROUND: To conduct radiologic anatomical study on the relation between S1 sacroiliac screws' entry points and the route of the pelvic outer superior gluteal artery branches with the aim to provide the anatomical basis and technical reference for the avoidance of damage to the superior gluteal artery during the horizontal sacroiliac screw placement. METHODS: Superior gluteal artery CTA (CT angiography) vascular imaging of 74 healthy adults (37 women and 37 men) was done with 128-slice spiral CT (computed tomography)...
January 18, 2018: Journal of Orthopaedic Surgery and Research
F Li, S F Wang, P C Li, Y H Xue
Objective: To observe the possibility of posterior approach via sacrectomy for reaching intrapelvic sacral plexus and expose the deep intrapelvic origin of sciatic nerve from sacral plexus in order to perform nerve graft. Methods: Five adult cadaver specimens were used in the study with prone position in May 2012. Cut off the gluteus maximus along the origins and lift to the lateral side, the piriformis was lay beneath. The sciatic nerve and the inferior gluteal nerve pierced from the infrapiriformis foramen in the operative field...
December 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Ramon Balius, Antonio Susín, Carles Morros, Montse Pujol, Dolores Pérez-Cuenca, Xavier Sala-Blanch
OBJECTIVE: To investigate the behavior of the sciatic nerve during hip rotation at subgluteal space. MATERIALS AND METHODS: Sonographic examination (high-resolution ultrasound machine at 5.0-14 MHZ) of the gemelli-obturator internus complex following two approaches: (1) a study on cadavers and (2) a study on healthy volunteers. The cadavers were examined in pronation, pelvis-fixed position by forcing internal and external rotations of the hip with the knee in 90° flexion...
December 7, 2017: Skeletal Radiology
Stéphane Ploteau, Roger Robert, Luc Bruyninx, Jérome Rigaud, Katleen Jottard
AIM: To describe a new minimal invasive approach of the gluteal region which will permit to perform neurolysis of the pudendal and cluneal nerves in case of perineal neuralgia due to an entrapment of these nerve trunks. METHOD: Ten transgluteal approaches were performed on five cadavers. Relevant anatomic structures were dissected and further described. Neurolysis of the pudendal nerve or cluneal nerves were performed. Landmarks for secure intraoperative navigation were indicated...
October 26, 2017: Neurourology and Urodynamics
Slavcho Stojmenski, Igor Merdzanovski, Andrej Gavrilovski, Sofija Pejkova, Gjorge Dzokic, Smilja Tudzarova
AIM: The aim of this paper was to present a case with the successful treatment of decubitis ulcer stage IV in the patient with polytrauma and vertical share pelvic fracture and diagnosed entherocollitis combined with deep wound infection with Clostridium difficile treated with combined Negative Pressure Wound Therapy (NPWT) and faecal management system. CASE REPORT: Patient D.S.1967 treated on Traumatology Clinic after tentamen suicide on 9.2.2015 with diagnosis: brain contusion; contusion of thoracal space; vertical share pelvic fracture; open fracture type II of the right calcaneus; fracture of the left calcaneus; fracture on the typical place of the left radius; fracture of the right radius with dislocation...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
Naoki Nakano, Grace Yip, Vikas Khanduja
PURPOSE: Extra-articular hip impingement syndromes encompass a group of conditions that have previously been an unrecognised source of pain in the hip and on occasion been associated with intra-articular hip impingement as well. As arthroscopic techniques for the hip continue to evolve, the importance of these conditions has been recognised recently and now form an important part of the differential of an individual presenting with hip pain. The aim of this article, therefore, is to provide the reader with an evidence-based and comprehensive update of these syndromes...
July 2017: International Orthopaedics
Luis Perez Carro, Moises Fernandez Hernando, Luis Cerezal, Ivan Saenz Navarro, Ana Alfonso Fernandez, Alexander Ortiz Castillo
BACKGROUND: Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included "piriformis syndrome", a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes...
July 2016: Muscles, Ligaments and Tendons Journal
Robert M Dorman, Kathryn D Bass
BACKGROUND: Extracellular matrix is used in various applications. We present our preliminary experience using a new device that consists of a porcine extracellular matrix with an epithelial basement membrane (MatriStem(®), ACell, Inc. Columbia, MD, USA) for adolescent pilonidal disease. METHODS: A retrospective review of four patients with pilonidal disease was undertaken. Three occurred in the gluteal cleft, and the fourth in the umbilicus. In the first patient, the wound deficit was filled with lyophilized MicroMatrix powder and a sheet of Multilayer Wound Matrix was placed to cover the wound...
October 2016: Pediatric Surgery International
Hal David Martin, Manoj Reddy, Juan Gómez-Hoyos
Deep gluteal syndrome describes the presence of pain in the buttock caused from non-discogenic and extrapelvic entrapment of the sciatic nerve. Several structures can be involved in sciatic nerve entrapment within the gluteal space. A comprehensive history and physical examination can orientate the specific site where the sciatic nerve is entrapped, as well as several radiological signs that support the suspected diagnosis. Failure to identify the cause of pain in a timely manner can increase pain perception, and affect mental control, patient hope and consequently quality of life...
July 2015: Journal of Hip Preservation Surgery
John W Thomas Byrd
Arthroscopic techniques for the hip joint have evolved into endoscopic methods for extra-articular disorders. These endoscopic strategies provide a less invasive alternative to open procedures for traditionally recognized forms of pathology. Endoscopy has defined new disorders amenable to surgical correction and has redefined some of these existing disorders. The peritrochanteric and deep gluteal regions represent 2 of the most currently active areas of exploration. Peritrochanteric problems include trochanteric bursitis, full-thickness and partial-thickness tears of the abductors including the gluteus medius and minimus, and external coxa saltans (snapping iliotibial band)...
December 2015: Sports Medicine and Arthroscopy Review
Moisés Fernández Hernando, Luis Cerezal, Luis Pérez-Carro, Faustino Abascal, Ana Canga
Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included "piriformis syndrome," a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes...
July 2015: Skeletal Radiology
Elizabeth A Howse, Sandeep Mannava, Cüneyt Tamam, Hal D Martin, Miriam A Bredella, Allston J Stubbs
Ischiofemoral space impingement has become an increasingly recognized extracapsular cause of atypical hip, deep gluteal, and groin pain that can be treated endoscopically. We present a minimally invasive posterolateral technique that preserves the attachment of the iliopsoas tendon and quadratus femoris insertion while decompressing the ischiofemoral space by resecting the lesser trochanter. Furthermore, we present tips to perform this technique in a manner that minimizes the potential for damage to the sciatic nerve...
December 2014: Arthroscopy Techniques
Alysson Zanatta, Mateus M Rosin, Ricardo L Machado, Leonardo Cava, Marc Possover
STUDY OBJECTIVE: To demonstrate the technique of laparoscopic dissection for identification of sacral nerve roots and pelvic splanchnic nerves. DESIGN: Case report (Canadian Task Force classification III). SETTING: Private practice hospital in São Paulo, Brazil. PATIENT: A 31-year-old woman with suspected iatrogenic and/or compression of sacral nerve roots. She reported debilitating pelvic, gluteal, and perineal unilateral left-sided pain (score 8 on a pain scale of 0-10), and had primary infertility with 1 previous failed attempt at in vitro fertilization...
November 2014: Journal of Minimally Invasive Gynecology
Hal David Martin, Ian James Palmer, Munif Hatem
PURPOSE: The purpose of this study was to evaluate the temperature at the sciatic nerve when using a monopolar radiofrequency (RF) probe to control bleeding in deep gluteal space endoscopy, as well as assess the fluid temperature profile. METHODS: Ten hips in 5 fresh-frozen human cadaveric specimens from the abdomen to the toes were used for this experiment. Temperatures were measured at the sciatic nerve after 2, 5, and 10 seconds of continuous RF probe activation over an adjacent vessel, a branch of the inferior gluteal artery...
January 2014: Arthroscopy: the Journal of Arthroscopic & related Surgery
Dae Gy Hong, Gun Oh Chong, Young Lae Cho, Il Soo Park, Ji Young Park, Yoon Soon Lee
INTRODUCTION: Aggressive angiomyxoma is a rare myxedematous mesenchymal tumor that mainly occurs in the female pelvis and perineum. The principle of treatment for aggressive angiomyxoma is surgical excision. The tumor can be removed by local excision alone when it occurs locally on the perineum. However, it cannot be completely excised by a perineal approach alone when it passes through the perineum and pelvic bone to extend into the retroperitoneal space. CASE PRESENTATION: A 34-year-old Asian woman presented with a rapidly growing left perineal mass and swelling in the left gluteal region...
2013: Journal of Medical Case Reports
A Ishizawa, S Hayashi, H Nasu, H Abe, J F Rodríguez-Vázquez, G Murakami
Birds and reptiles always carry a long and thick artery accompanying the sciatic nerve (i.e., the sciatic artery), whereas mammals do not. We attempted to demonstrate a difference in courses of the nerve and artery in fetuses in relation with the hip joint posture. Eight mid-term human fetuses (15-18 weeks), five mouse fetuses (E18) and five chick embryos (11 days after incubation) were examined histologically. Thin feeding arteries in the sciatic nerve were consistently observed in human fetuses in spite of the long, inferiorly curved course of the nerve around the ischium...
February 2013: Folia Morphologica (Warsz)
Memet Yazar, Sevgi Kurt Yazar, Burcu Celet Ozden, Erdem Guven, Karaca Basaran, Alper Alyanak, Atakan Aydin
The optimal treatment of the pilonidal sinus has not currently been defined. This study described the use of a modified bilateral transpositional adipofascial flap technique that effectively serves to flatten the deep natal cleft while keeping the scar limited to the intergluteal fold for good cosmesis. Between June 2007 and September 2011, 83 patients (61 men, 22 women) were included in the study. Duration of pilonidal sinus symptoms ranged from 1-15 (median 5) years; 15 patients had recurrent disease. Before the operation, perforating branches of the four pairs of lateral sacral arteries were identified with a Doppler audioscope...
September 2013: Journal of Plastic Surgery and Hand Surgery
T Sean Lynch, Michael A Terry, Asheesh Bedi, Bryan T Kelly
Arthroscopic surgery in the hip joint has historically lagged behind its counterparts in the shoulder and knee. However, the management of hip injuries in the athletic population has rapidly evolved over the past decade with our improved understanding of mechanical hip pathology as well as the marked improvement in imaging modalities and arthroscopic techniques. Current indications for hip arthroscopic surgery may include symptomatic labral tears, femoroacetabular impingement (FAI), hip capsular laxity/instability, chondral lesions, disorders of the peritrochanteric or deep gluteal space, septic joint, loose bodies, and ligamentum teres injuries...
May 2013: American Journal of Sports Medicine
Massimo Tonolini, Anna Ravelli, Alessandro Campari, Roberto Bianco
Pelvic osteomyelitis is a very uncommon complication of Crohn's disease, usually clinically unsuspected in the setting of acute Crohn's disease relapses. The case of a 21-year old patient is reported, in whom ileo-cecal inflammatory disease was complicated by fistulization to the presacral space and sacral osteomyelitis, plus multiple abscesses involving the iliopsoas, posterior paravertebral and gluteal muscles. As confirmed by surgical and pathological findings, MRI provided comprehensive imaging diagnosis by demonstrating both the pathogenesis and the full extent of the complex, deep pelvic inflammatory process...
October 2011: Journal of Crohn's & Colitis
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