Conservative versus Surgical Management of Post-injection Sciatic Nerve Injury in Children

Background Data: Intramuscular injection in the gluteal region represents one of the most important causes of sciatic nerve palsy. The main manifestation of most patients is foot drop and/or sciatic pain. Purpose: to evaluate the role of surgical exploration of post-injection sciatic nerve injury i...

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Autores principales:	Ebrahim Shamout, Ahmed ElKholy, Hend Abdelnabi
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2017
Materias:	Sciatic nerve injury surgical exploration conservative management intragluteal injection Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/b1e6ee4a5c6d45e699aaff2fcd5677d4
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spelling	oai:doaj.org-article:b1e6ee4a5c6d45e699aaff2fcd5677d42021-12-02T09:41:41ZConservative versus Surgical Management of Post-injection Sciatic Nerve Injury in ChildrenDOI:10.21608/ESJ.2017.67562314-89502314-8969https://doaj.org/article/b1e6ee4a5c6d45e699aaff2fcd5677d42017-07-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_6756.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Intramuscular injection in the gluteal region represents one of the most important causes of sciatic nerve palsy. The main manifestation of most patients is foot drop and/or sciatic pain. Purpose: to evaluate the role of surgical exploration of post-injection sciatic nerve injury in reference to conservative treatment. Study Design: A retrospective cohort study. Patients and Methods: Reviewing our hospital medical records revealed 16 children with post injection sciatic nerve injury. All were included in this study. The mean age was 4.35±1.98 with range 1.5-8 years. Five children (31.3%) were females and 11 (68.8%) were males. All diagnosed by history, clinical examination, electrophysiological, functional assessment. All failed conservative treatment for 3 month and then either allocated for surgical exploration (N=10) or further conservative management (N=6) based on patients’ choice. All were followed routinely clinically and electrophysiologically. Results: Group I underwent surgical exploration and group II treated conservatively. The 3 months post-injection data were homogenous in both groups. Vasomotor changes, sensory loss and foot drop were the commonest manifestations in the 2 groups; right foot drop was more common than the left one (13 versus 3 children). Antibiotics and analgesics were the commonest causative agents of nerve injury in the studied children. Initial EMG were done for all cases at initial presentation and revealed sciatic nerve injury with complete degeneration of common peroneal nerve. Surgical exploration revealed peri-neural adhesions in all children. Follow up EMG at 3, 6 and 12 months shown complete improvement in 8 cases, partial improvement in one case and no improvement in one case in group-I. In group-II there was no reported improvement in 4 and partial improvement in 2 children with significant difference between the two groups (P=0.011). Conclusion: Surgical exploration of post injection sciatic nerve injury in children is feasible and effective management in reference to conservative methods. (2017ESJ142)Ebrahim Shamout Ahmed ElKholy Hend AbdelnabiEgyptian Spine AssociationarticleSciatic nerve injurysurgical explorationconservative managementintragluteal injectionNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 23, Iss 1, Pp 29-35 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sciatic nerve injury surgical exploration conservative management intragluteal injection Neurology. Diseases of the nervous system RC346-429
spellingShingle	Sciatic nerve injury surgical exploration conservative management intragluteal injection Neurology. Diseases of the nervous system RC346-429 Ebrahim Shamout Ahmed ElKholy Hend Abdelnabi Conservative versus Surgical Management of Post-injection Sciatic Nerve Injury in Children
description	Background Data: Intramuscular injection in the gluteal region represents one of the most important causes of sciatic nerve palsy. The main manifestation of most patients is foot drop and/or sciatic pain. Purpose: to evaluate the role of surgical exploration of post-injection sciatic nerve injury in reference to conservative treatment. Study Design: A retrospective cohort study. Patients and Methods: Reviewing our hospital medical records revealed 16 children with post injection sciatic nerve injury. All were included in this study. The mean age was 4.35±1.98 with range 1.5-8 years. Five children (31.3%) were females and 11 (68.8%) were males. All diagnosed by history, clinical examination, electrophysiological, functional assessment. All failed conservative treatment for 3 month and then either allocated for surgical exploration (N=10) or further conservative management (N=6) based on patients’ choice. All were followed routinely clinically and electrophysiologically. Results: Group I underwent surgical exploration and group II treated conservatively. The 3 months post-injection data were homogenous in both groups. Vasomotor changes, sensory loss and foot drop were the commonest manifestations in the 2 groups; right foot drop was more common than the left one (13 versus 3 children). Antibiotics and analgesics were the commonest causative agents of nerve injury in the studied children. Initial EMG were done for all cases at initial presentation and revealed sciatic nerve injury with complete degeneration of common peroneal nerve. Surgical exploration revealed peri-neural adhesions in all children. Follow up EMG at 3, 6 and 12 months shown complete improvement in 8 cases, partial improvement in one case and no improvement in one case in group-I. In group-II there was no reported improvement in 4 and partial improvement in 2 children with significant difference between the two groups (P=0.011). Conclusion: Surgical exploration of post injection sciatic nerve injury in children is feasible and effective management in reference to conservative methods. (2017ESJ142)
format	article
author	Ebrahim Shamout Ahmed ElKholy Hend Abdelnabi
author_facet	Ebrahim Shamout Ahmed ElKholy Hend Abdelnabi
author_sort	Ebrahim Shamout
title	Conservative versus Surgical Management of Post-injection Sciatic Nerve Injury in Children
title_short	Conservative versus Surgical Management of Post-injection Sciatic Nerve Injury in Children
title_full	Conservative versus Surgical Management of Post-injection Sciatic Nerve Injury in Children
title_fullStr	Conservative versus Surgical Management of Post-injection Sciatic Nerve Injury in Children
title_full_unstemmed	Conservative versus Surgical Management of Post-injection Sciatic Nerve Injury in Children
title_sort	conservative versus surgical management of post-injection sciatic nerve injury in children
publisher	Egyptian Spine Association
publishDate	2017
url	https://doaj.org/article/b1e6ee4a5c6d45e699aaff2fcd5677d4
work_keys_str_mv	AT ebrahimshamout conservativeversussurgicalmanagementofpostinjectionsciaticnerveinjuryinchildren AT ahmedelkholy conservativeversussurgicalmanagementofpostinjectionsciaticnerveinjuryinchildren AT hendabdelnabi conservativeversussurgicalmanagementofpostinjectionsciaticnerveinjuryinchildren
_version_	1718398083295870976

Conservative versus Surgical Management of Post-injection Sciatic Nerve Injury in Children

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