Turkish Neurosurgery 2017 , Vol 27 , Num 4
Preventing Sciatic Nerve Injury due to Intramuscular Injection: Ten-Year Single-Center Experience and Literature Review
Sirma GEYIK1,Murat GEYIK2,Remzi YIGITER1,Samiye KUZUDISLI3, Sadullah SAGLAM4,Mehmet Ali ELCI5,Mustafa YILMAZ6,
1Gaziantep University, School of Medicine, Department of Neurology, Gaziantep, Turkey
2Gaziantep University, School of Medicine, Department of Neurosurgery, Gaziantep, Turkey
3Zirve University, EBN School of Medicine, Department of Neurology, Gaziantep, Turkey
4Adiyaman University, School of Medicine, Department of Neurology, Adiyaman, Turkey
5Kırıkhan State Hospital, Department of Neurology, Antakya, Turkey
6Fatih University, School of Medicine, Department of Neurology, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.16956-16.1 AIM: Sciatic nerve injury is the most frequent and serious complication of intramuscular gluteal injection. This study aims to highlight the incidence and causes of this continuing problem and to discuss the relevant literature.MATERIAL and METHODS: A total of 217 subjects who were diagnosed with sciatic nerve injury in our neurophysiology laboratory between 2003 and 2013 were examined. Sensory and motor transmission studies and needle electromyography were performed by conventional methods in the two lower legs and the results were compared between each leg.

RESULTS: Of the subjects who experienced a sciatic injury secondary to intramuscular injection, 59 (27.2%) were female and 158 (72.8%) were male. In all subjects, the dorsogluteal site of the buttocks was selected for intramuscular injection. Sciatica occurred on the right side in 91 subjects, on the left side in 125, and bilaterally in one. The peroneal nerve was more affected than the tibial nerve. The most used agents were non-steroidal anti-inflammatory drugs. According to follow-up electromyography findings of 103 subjects, significant sequelae remained in 2/3 of cases.

CONCLUSION: The occurrence of sciatic neuropathy after gluteal injection causing permanent sequelae and leading to medicolegal problems is relatively rare. We suggest a double quadrant drawing technique in each gluteal region. We also draw attention to this issue with postgraduate and in-service training programs of medical staff, and providing continuity in education can reduce this serious complication. Keywords : Intramuscular injection, Sciatic nerve injury, Electrophysiology, Malpractice

Corresponding author : Sirma GEYIK, drsirmageyik@hotmail.com