To describe the anatomy and MRI appearance of the subgluteal space (SS) and perform correlation with arthroscopic findings.
To review known etiologies of deep gluteal syndrome and introduce new ones.
To evaluate the use of magnetic resonance neurography (MRN) in the sciatic nerve entrapments in patients with unexplained sciatica.
To describe the management of pathologic conditions of the SS and the role of the radiologist in the diagnosis,
treatment and postoperative evaluation.
Deep gluteal síndrome is an underdiagnosis entity characterized by pain and dysesthesias in the buttock área,
hip or posterior thigh and/or radicular pain,
secondary to a nondiscogenic sciatic nerve entrapment in the subgluteal space.
It is known that extrasespinal sacral plexus and sciatic nerve entrapments may be result from a high espectrum of extrapelvic (within the subgluteal space) or intrapelvic pathology.
Due to the variation of anatomical entrapment,
the term “deep gluteal syndrome” may be a more accurate description of this nondiscogenic sciatica.
Imaging findings OR Procedure details
Being familiar with the anatomy of the sacral plexus,
sciatic nerve and subgluteal space is essential for the evaluation of deep gluteal syndrome.
Subgluteal space (SS) is the cellular and fatty tissue situated between the middle and deep gluteal aponeurosis layers.
Its posterior limit is formed by the gluteus maximus muscle,
which is inserted medially in the posterior fourth of the iliac crest,
behind the posterior semicircular line of the external iliac fossa,
sacral crest and sacrotuberous ligament and laterally on the lateral ridge...
The etiology of Deep Gluteal Syndrome is multifactorial so imaging studies are essential before any therapeutic action.
MRI is the diagnostic procedure of choice for assessing the deep gluteal syndrome and may substantially influence the management of these patients.
A common and underdiagnosed causerecently known of sciatic nerve entrapment is the formation of fibrovascular bands secondary to acute or chronic inflammatory pathology in the subgluteal space.
Multiple orthopedic non-orthopaedic entities can cause DGS by this mechanism.
These bands can be identified by MRI with an...
The endoscopic treatment of sciatic nerve entrapment/deep gluteal syndrome.
Artrroscopy 2011 Feb;27(2):172-81.
CT evaluation of the greatre sciatic foramen in patiens with sciatica.
J Radiol 2010 Sep;83(993):791-803.
Lower-extremity peripheral nerve blockade: essentials of our current understanding.
Reg Anesth Pain Aneth Pain Med 2005 Jan-Feb;30(1):4-35.
Magnetic resonance neurography in extraspinal sciatica.