Turkish Neurosurgery
PREVENTİNG SCIATIC NERVE INJURY DUE TO INTRAMUSCULER INJECTION MALPRACTİCE: A LITERATURE REVİEW AND TEN YEARS SINGLE CENTER EXPERIENCE
Sırma Geyik1, Murat Geyik2, Remzi Yiğiter1, Samiye Kuzudişli3, Sadullah Sağlam4, Mehmet Ali Elçi5, Mustafa Yılmaz6
1Gaziantep University, School of Medicine, Neurology, Gaziantep,
2Gaziantep University, School of Medicine, Neurosurgery, Gaziantep,
3Zirve University, EBN School of Medicine , Neurology, Gaziantep,
4Adiyaman University, School of Medicine, Neurology, Adıyaman,
5Kırıkhan State Hospital, Neurology, Antakya,
6Fatih University, School of Medicine, Neurology, İstanbul,
DOI: 10.5137/1019-5149.JTN.16956-16.1

Aim: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: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:RESULTS: Of the subjects who experienced a sciatic injury because of 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:CONCLUSION: The occurrence of sciatic neuropathy after gluteal injection causing permanent sequelae and leading to medicolegal problems is relatively rare. We suggest 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.

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