The document summarizes sciatic nerve injury, including: - The sciatic nerve originates from the lumbar and sacral plexus and innervates muscles in the back of the thigh and leg. - Sciatic nerve injury can occur due to trauma that causes pressure, stretching, or cutting of the nerve, resulting in muscle weakness. - Common causes include spinal stenosis, hip dislocation or fracture from trauma. - Signs and symptoms include foot drop, muscle wasting, sensory loss below the knee, and pain along the back of the thigh. Management includes nonsurgical options like physical therapy and injections or potential surgical interventions like laminectomy or microdissection.

1. SCIATIC NERVE INJURY
PRESENTED BY SUDHAMOY MAITY
3RD YEAR BPT STUDENT
NIHS, KOLKATA

2. • SCIATIC NERVE :-
• ORIGIN – IT ORIGINATED FROM L4,L5,S1,S2,S3 LUMBOSACRAL
PLEXUS
• COURSES - IT LEAVES THE PELVIS AND ENTERS THE GLUTEAL
REGION VIA GREATER SCIATIC FORAMEN. IT EMERGES INFERIORLY
TO THE PIRIFORMIS MUSCLE AND DESCENDS IN AN
INFEROLATERAL DIRECTION.
TERMINATION – IN THE MIDDLE OF THE BACK OF THE THIGH. IT DIVIDED INTO
TWO TERMINAL BRANCH- TIBIAL NERVE AND COMMON PERONIAL NERVE.
MUSCLES SUPPLIED BY SCIATIC NERVE – SEMITENDINOSUS,
SEMIMEMBRANOSUS, LONG AND SHORT HEAD OF BICEPS FEMORIS,
ADDUCTOR MAGNUS.
• SENSORY SUPPLY- POSTERIOR ASPECT OF THIGH

3. DEFINITION
•SCIATIC NERVE INJURY CAN OCCUR
DUE TO TRAUMA (PRESSURE,
STRETCHING OR CUTTING) TO THE
NERVE. THIS TYPE OF INJURY CAN
CAUSE DEGREES OF MUSCLE POWER

4. CAUSES
1. SPINAL STENOSIS
2. SPONDYLOLISTHESIS
3. PIRIFORMIS SYNDROME
4. GUNSHOT
5. ANY TRAUMA THAT LEDS TO HIP DISLOCATION
AND ACETABULAM FRACTURE
6. INJECTION PALSY
7. TOTAL HIP JOINT REPLACEMENT

5. SIGN AND SYMPTOM
1. WEAK FLEXION OF KNEE
2. FOOT DROP
3. WASTING OF CUFF MUSCLE
4. LOSS OF ACHILIS TENDON REFLEX
5. TROPHIC ULCER
6. SENSORY LOSS BELOW THE KNEE
(EXCEPT THE AREA SUPPLIES BY SAPHENOUS NERVE)
7. SCIATICA – PAIN ALONG THE POSTERIOR ASPECT
OF THIGH

6. ASSESSMENT AND DIAGNOSIS
•SLR TEST -

7. CONT…..
•SLUM TEST -

8. CONT……
• SPINAL X-RAY
•NERVE CONDUCTION VELOCITY TEST/
• ELECTROMYOGHARPHY TEST
• MRI /CT SCAN
•MYELOGRAM

9. MANAGEMENT
• NON SURGICAL MANAGEMENT –
1. NSAIDS CAN USE FOR REDUCED PAIN, INFLAMMATION, SWELLING
2.PHYSICAL THERAPY: THE GOAL OF PHYSICAL THERAPY IS TO FIND
EXERCISE MOVEMENTS THAT DECREASE SCIATICA BY REDUCING
PRESSURE ON THE NERVE. AN EXERCISE PROGRAM SHOULD INCLUDE
STRETCHING EXERCISES AND AEROBIC EXERCISES (SUCH AS
WALKING, SWIMMING, WATER AEROBICS)TO IMPROVE MUSCLE
FLEXIBILITY.
3.SPINAL INJECTIONS: AN INJECTION OF A CORTICOSTEROID, AN
ANTI-INFLAMMATORY MEDICINE, INTO THE LOWER BACK MIGHT
HELP REDUCE THE PAIN AND SWELLING AROUND THE AFFECTED

10. CONT……
• SURGICAL MANAGEMENT –
1. LAMINECTOMY- IT IS MOST COMMONLY DONE FOR SCIATICA PAIN CAUSED
BY LUMBAR SPINAL STENOSIS.

11. CONT…
• MICRODISCECTOMY: THIS IS A MINIMALLY INVASIVE PROCEDURE
USED TO REMOVE FRAGMENTS OF A HERNIATED DISK THAT ARE
PRESSING ON A NERVE.

12. CONT….
• URGENT SURGICALLY REDUCTION OF HIP
DISLOCATION
• PROPER TREATMENT OF FRACTURE
• OPEN WOUND REPAIR
• A DROP FOOT SPLINT CAN BE FITTED
•

13. THANK YOU