A rare case of
chronic pain of entrapment neuropathy of the sciatic nerve successfully relieved by
surgical decompression is presented. A 71-year-old male suffered a chronic right buttock
pain of duration of 7 years which radiating to the right distal leg and foot. His
pain developed gradually over one year after underwenting drainage for the gluteal
abscess seven years ago. A cramping buttock and intermittently
radiating pain to his right foot on sitting, walking, and voiding did not respond to conventional treatment. An MRI suggested a post-inflammatory adhesion encroaching the proximal course of the sciatic nerve beneath the piriformis as it emerges from the sciatic notch. Upon exploration of the sciatic nerve, a fibrotic tendinous
scar beneath the piriformis was found and released proximally to the sciatic notch. His chronic
intractable pain was completely relieved within days after the
decompression. However, thigh weakness and
hypesthesia of the foot did not improve. This case suggest a need for of more prompt investigation and
decompression of the chronic sciatic entrapment neuropathy which does not improve clinically or electrically over several months.