[Piriformis Surgery] Piriformis surgery on 9/8/09

[rob wilson]

I have waited to write about my recent left sided piriformis surgery until I felt that I could report concrete results. My surgery was performed by Dr. Henry Bohlman of University Hospital in Cleveland, Ohio on 9/8/09. I believe that he has performed well over 100 of these surgeries. I was very sacred to have this surgery but felt I had little option if I was going to rid myself of my continuing sciatica pain, butt pain, hip pain and leg cramping. I even had low back pain and upper back tightness (opposite side due to body compensating). I had many diagnostic tests (SI joint injections, selective nerve root blocks, foramen injections, prolotherapy of various SI ligaments, RF ablation of the L4, L5, S1, S2, S3 medial branches) to rule out other issues. I had many different types of treatment including trigger point massage therapy, chiropractic, prolotherapy, and ART (active release technique). Once I felt comfortable it was piriformis syndrome and that all my conservative measures would not get me where I wanted to be I made a visit to Dr. Bohlman. I also consulted with a number of people who had this same surgery and surgeon. Dr. Bohlamn determined that I had piriformis purely by exam and the fact that I had already had ADR at L4/5 and L5/S1 and decompression of the L5 and S1 nerves and the aforementioned diagnostics. I proceeded with surgery soon thereafter. It entailed separating the gluteal maximus muscle down to the piriformis muscle, removing the entire piriformis muscle, and decompressing any fibrous tissue and arteriovenous abnormalities around the sciatic nerve. The surgery only took ~ 45 minutes and I walked out of the hospital with no aid. Very very sore. I was out of work for ~ 2 weeks and then gradually began back to work beginning with 4 hours a day. Now I am 6 ½ weeks out of surgery and have seen steady improvement. My major cramping is gone. The low back pain is gone. The upper back tightness is gone. I still have some sciatica and pain but it is slowly improving. I continue to hope that I will have great results once my body has fully healed. This could take a long time but I am very happy I had this surgery so far.

I have something similar going on with my right side but MUCH less than the left side. The ART is helping.

[Justin]

Hi Rob,

It is great to "see" you. Dr. Bohlman sounds like he was the surgeon to go to in terms of piriformis issues. In our previous discussions and in your post above, it is evident that you tried everything under the sun before undergoing this operation.

Piriformis issues can be tricky to diagnose (from what I have heard, as many patient complaints can look like piriformis problems but are ultimately attributed to other issues). Dr. Bohlamn's experience and confirmation of piriformis syndrome must have been a relief to you after your tireless work-up utilizing numerous diagnostics.

During the initial two weeks after surgery, what limitations were you given in terms of time on your feet, bed rest, etc?

Now I am 6 ½ weeks out of surgery and have seen steady improvement. My major cramping is gone. The low back pain is gone. The upper back tightness is gone. I still have some sciatica and pain but it is slowly improving. I continue to hope that I will have great results once my body has fully healed. This could take a long time but I am very happy I had this surgery so far.

Rob, I am so happy that your low back pain and cramping is GONE! This is incredible.

I truly wonder if the compensatory mechanisms that your body established to "work through" the piriformis syndrome pain and dysfunction were the main culprits in the cramping and upper spine issues. It makes sense that they would inherently be related.

I'm sure you will see continued improvement for many months to come, as more of the subtle compensatory issues work themselves out. Please keep us posted on your recovery.

[rob wilson]

Justin,

Thanks for your support and always listening. The first 2 weeks I just had to listen to my body. You are so sore and painful. The only real restriction is not to stretch or pull the butt area.

[Phylly]

Rob,
Thank you for posting, I have been waiting to hear how you were doing. This is something that I have considered so I will follow your thread closely and hope that you continue with a great recovery. I can imagine how sore you must be expeicially sitting on your behind-yikes! Did your Dr. remove the whole muscle or just release the areas where it was constricted by the muscle?
Again my best wishes to you and keep posting.
Phylly

[rob wilson]

Dr. Bohlman removes the complete muscle. Dr. Filler just detaches.

[Cindylou]

Wow. Very interesting Rob. I can't say that I have ever even heard of this surgery before. I'm impressed with all the homework you did leading up to it, which is so critical. Ultimately, diagnosing the pain generator is a bug-a-boo in and of itself. I will also be eagerly watching for your posts, and my very best to you in this healing phase.

[daveinaustin]

Congratulations to you and Dr. Bohlman for determining the root cause of this complicated pain issue!

-Dave

[Terry Newton]

WoW Rob! You sure have gone through hell and back in the last few years. Let's hope that this is it and that you will get your life back.

[rob wilson]

Terry,

Nice to hear from you. Yeah it has been quite journey. Now my opposite right side is giving me issues. Don't know if it is SI joint or piriformis. Think it is SI. I have a good pain guy who will figure it out. Neverending but I remain joyful in the Lord. Need to be thankful for what I have which is a lot.

How are you feeling?

[Phylly]

Hello Rob,
Just wondering how the recovery from your piriformis is coming? Do you feel it has helped? Please post an update. Have a Happy Thanksgiving.
Phylly