It can be subject to direct traumatic injury including severance, chronic compression or traction injury along its whole course from the deep gluteal region to the popliteal fossa 1,2,4.
The sciatic nerve is a mixed motor and sensory nerve formed by the L4-S3 nerve roots supplying motor innervation to the posterior thigh muscles and the vast majority of motor and sensory innervation to the lower leg via the tibial and common peroneal nerves 1,2,4. Nerve conduction studies will reveal reduced amplitudes of the superficial peroneal and sural sensory stimulations as well as low tibial and peroneal motor responses but without evidence of conduction block at the knee 2,4. Achilles and hamstring reflexes might be diminished 2.Ĭlinical symptoms will be sometimes less obvious and resemble peroneal nerve neuropathy due to incomplete injury to the nerve 2. Motor symptoms include foot drop and weakness in knee flexion and hip extension due to affection of the hamstring muscles 1-4. Numbness and weakness often develop more gradually than pain 3. The clinical symptom of sciatic neuropathy is sciatica and includes sharp pain and paresthesia along the posterior thigh and lower leg including the lateral and plantar aspects of the foot. Imaging studies such as MRI and ultrasound might show denervation changes in the affected muscles and help to identify the location of an entrapment site and provide clues about the etiology 2. Differential diagnoses as lumbosacral radiculopathy should be ruled out.
The diagnosis can be made on clinical grounds and might be confirmed with electrodiagnostic tests like nerve conduction studies and electromyography 1. Sciatic neuropathy is associated with hip arthroplasty with an incidence of up to 1-3% 2,3,5. Sciatic neuropathy is a very common neuropathy of the lower extremity even if not quite as frequent as common peroneal neuropathy 3.
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