23例梨状肌综合征误诊为腰突症分析

目的：鉴别梨状肌综合征与腰突症，提高诊断符合率。方法：对23例曾误诊为腰突症的梨状肌综合征的确诊过程进行回顾性分析，寻求诊断思路和鉴别要点。结果：23例均有臀腿麻痛，但具有典型梨状肌综合征症状和体征者仅6例，CT检查有3例显东腰椎间盘突出。全部病例均按软组织外科学理论和方法，结合其他临床方法进行程式化诊断，并经治疗验证为梨状肌综合征。20例经坐骨神经阻滞、梨状肌肌腹注射等非手术治疗、3例经行坐骨神经探查减压术治疗，优良率为95％。结论：软组织外科学理论和方法在程式化诊断梨状肌综合征中的作用突出。

Analysis of 23 cases of piriformis syndrome misdiagnosed as lumbar disc herniation

Objective:To elevate the diagnostic coincident rate of piriformis syndrome by differentiating it from lumbar disc herniation. Methods:23 patients suffering from piriformis syndrome misdiagnosed as lumbar disc herniation were analysed retrospectively,and the diagnostic train of thought and differential main points were studied. Results:All 23 cases had haunch-crural numbness or pain,among them,only 6 cases had typical symptoms and signs of piriformis syndrome,CT displayed the lumbar intervertebral disc protrusion in 3 cases. All cases were diagnosed as piriformis syndrome according to the diagnostic program of the theories and methods of soft tissue surgery combined with other clinical methods,and were tested by the treatment. The non-operative treatments,such as sciatic nerve block,venter musculi injection of piriformis etc were used in 20 cases,the exploratory operation and decompression of sciatic nerve were used in 3 cases,the good rate was 95%. Conclusion:The diagnostic program based on the theories and methods of soft tissue surgery plays an important role in diagnosing piriformis syndrome.