CT Guided Botulinum Toxin Injection in Piriformis Syndrome.

, Kim, Chul; , Park, Yong Bum; , Kim, Duk You

Case Report

Journal of the Korean Academy of Rehabilitation Medicine 2009;33(3):353-356.

Kim, Chul , Park, Yong Bum , Kim, Duk You

Department of Rehabilitation Medicine, Inje University College of Medicine, Korea. kwdhim@hanmail.net

이상근 증후군에서의 CT 유도하 보툴리눔 독소 주사치료-증례 보고-

김철, 박용범, 김덕유

인제대학교 의과대학 재활의학교실

Abstract

The traditional treatment of piriformis syndrome includes heat modality, deep muscle massage, slow stretch exercise, injection of local anesthetics, and surgical division of piriformis muscles in some selected cases. More recently, the use of botulinum toxin (BTX) for the treatment of piriformis syndrome has been suggested. We experienced two cases of piriformis syndrome with distinctive clinical feature. The symptoms of these two cases were not controlled by conservative managements including physical therapy, direct injection of lidocaine or steroid, or caudal block. So we injected Type A BTX in the piriformis muscle with the guidance of CT scan. 8 weeks after the botulinum injection, symptoms had almost completely disappeared, and follow up CT scan showed sufficient atrophy of piriformis muscles. The CT guided BTX injection in the piriformis muscle might emerge as a feasible technique to obtain a good local therapeutic effect without risk of imprecise inoculation. (J Korean Acad Rehab Med 2009; 33: 353- 356)

Key Words: Piriformis syndrome, Botulinum A toxin, CT guided injection