Affiliations: [a] Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China | [b] Department of Orthopaedic Surgery, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China | [c] Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China | [d] Southern Medical University, Guangzhou, Guangdong, China
Correspondence:
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Corresponding author: Jun Xiao, Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China. Tel.: +86 18665000156; Fax: +86 020 62786240; E-mail: orthopaedxj@163.com.
Note: [1] Zhi-Fa Huang and Bing-Quan Lin contributed equally to this work.
Abstract: BACKGROUND: Piriformis syndrome (PS) is an entrapment of the sciatic nerve by the piriformis muscle, or myofascial pain from the piriformis muscle. OBJECTIVE: The aim of this study was to investigate the effectiveness of Mannitol plus Vitamins B regime in the management of PS. METHODS: Twenty two patients were included in this study and received 250 ml of mannitol 20% intravenous infusion for 5 days + Vitamins B (vitamin B1 10 mg + vitamin B2 10 mg + vitamin B12 50 μg PO) for 6 weeks. Clinical outcomes were assessed systematically by clinical tests (tenderness, FAIR test, Beatty’s, Freiberg’s and Pace’s maneuver), Numeric Rating Scale (NRS), Likert Analogue Scale (LAS), and MR examination. RESULTS: The clinical evaluations showed a significant reduction (p< 0.05) of tenderness, FAIR test, Beatty’s maneuver, Freiberg’s maneuver and Pace’s maneuver when compared with baseline evaluation during the 3rd and 6th month follow-ups. A statistically significant improvement of pain was measured by NRS at resting (p< 0.001), at night (p< 0.001) and during activities (p< 0.001) and LAS with prolonged sitting (p< 0.001), standing (p< 0.001) and lying (p< 0.001). Concomitantly, swelling of SN revealed a significant reduction (p= 0.003) from 86.4% to 18.2%. CONCLUSIONS: Mannitol plus Vitamins B is effective in the management of piriformis syndrome and it could be an alternative regime in treating PS.
