An endoscopic sciatic nerve release

One of few (in our country, among state clinics) examples of endoscopic sciatic nerve release (release from compression) is performed by doctors of MCCH after V.M. Buyanov by a multidisciplinary team of specialists – an orthopedic surgeon, M.D. Evgeniy Belyak and a neurosurgeon, M.D. Dmitry Paskhine.

Usually, when the sciatic nerve is squeezed by surrounding tissues and the medical or physiotherapy is ineffective, this procedure is performed surgically through "open access" (an incision that allows doctors to come close to the nerve and release it). But the "open access" technique has significant drawbacks: after the operation appears a scar and the process of postoperative recovery becomes much longer and more complicated than when using the endoscopic (minimally invasive) method.

At the beginning 2020, to out Clinic came a woman 32-year-old, who suffered from pain in her left leg and buttock. The reason for the appearance of the strongest pain sensations was the prosthetics of the hip joint, which that patient underwent about a year ago in another hospital. During the installation of the prosthesis, was injured the sciatic nerve, due to which the woman began to paresis of the foot, the leg began to grow numb, and most importantly the strongest feeling of pain. In fact, the woman could no longer lean on her injured leg. Unfortunately, a сonservative therapy could not help her.

After diagnostics (ultrasound and electroneuromyography) our doctors decided to resort to the operation by the endoscopic method. Through small punctures in the buttocks and thighs were inserted an endoscope, a shaver and an ablator (a video from the operation is available on the official channel of the Department of Traumatology and Orthopedics of PFUR: https://www.youtube.com/.../UCJDNQMC4CUYTsNSCbhHlhoA/videos), the nerve area was cleared along its entire length and were removed a connective tissue scars formed inside the thigh. Next day, the patient admitted that the pain sensations disappeared "by 80-90 percent", then the motor functions of the foot began to recover. During the medical examination, the woman leaned freely on her leg, not afraid to feel unbearable pain, and was able to move her fingers. Dr. Evgeniy Belyak is optimistic: there is every reason to believe that the patient will recover completely in the few coming months.

Such successful operations performed by multidisciplinary teams of doctors of our Clinic are frequent. They do it possible not only to help patients, but to develop the scientific and technical component of modern Moscow medicine.