Evidence map›Paper›PMID 41068685›Full record

SynthesisBMC surgery2025

Piriformis syndrome: a systematic review of case reports.

Giovanni Monteleone, Giorgio Stevanato, Maurizio Alimandi, Edoardo Cappa, Roberto Sorge

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Giovanni MonteleoneDepartment of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy. giovanni.monteleone@uniroma2.it.
Giorgio StevanatoNeurosurgery Unit, Dell'Angelo Hospital, Mestre (Ve), Italy.
Maurizio AlimandiDepartment of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.
Edoardo CappaDepartment of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.
Roberto SorgeDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo study the medical history, diagnosis, management, and treatment results of piriformis syndrome (PS).

methodsArticles published between 1980 and 2024 reporting cases of PS or piriformis muscle sciatica (PMs) case/case series were included. We excluded articles that did not report anagraphic data for singular cases, diagnostic procedure, therapy, and outcome for each case. We searched PubMed database and we retrieved articles from references. We used the Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines to conduct a systematic review of the literature to identify all published cases of PS or piriformis muscle sciatica (PM). Data for all cases were collected in a database and analysed using statistical software (Statistical Package for the Social Sciences for Windows).

resultsOf the 235 articles screened, 97 were included. Data from 212 patients (117 females and 95 males, mean age 43.6 ± 14.8) were collected. 38.2% of the patients in this study had a history of blunt / indirect pelvic trauma or piriform muscle (PM) stress due to vigorous physical activity/sport. 9.0% (19/212) of the patients had previously failed lumbar spine surgery. Before treatment, the diagnosis of PS/PMs was corroborated in 29.7% of patients by intrapelvic magnetic resonance imaging (MRI); 50.5% of the patients had a PS clinical diagnosis. Conservative treatments were effective in treating PS/PMs in 41.1% of patients; 58.9% of patients required surgical treatments. In the group of patients with PS diagnosis made without instrumental finding, the OR of surgical treatment failure occurrence was 5.3. After treatment, the most frequent causes of PS/PMs identified by intraoperative or instrumental findings were the anatomical variant of PM or SN (12.7%) followed by pyomyositis (9.4%) and PM hypertrophy (7.5%). 47.6% of the patients had no instrumental or intraoperative findings.

conclusionsIntrapelvic MRI was the instrumental examination most frequently used to confirm the diagnosis of PS/PMs prior to treatment. The PS causes most frequently identified were the anatomical variant of PM or SN. In the group of patients with PS diagnosis made without instrumental finding, the OR of surgical treatment failure occurrence was 5.3. To reduce the number of cases of persistent pain after treatment for suspected PS, it is advisable to support the clinical diagnosis through all available instrumental diagnostic procedures. However, considering all the risks that SN surgery can cause, all nonsurgical treatments should be encouraged prior to surgery. 

trial registrationPROSPERO Reg. No. CRD42025641061.

Indexed as

Piriformis Muscle SyndromeAdultFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedCase reportsIntrapelvic sciatic nerve entrapmentPiriformis muscle sciaticaPiriformis syndrome

Identifiers

PMID41068685
PMCPMC12512919

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.