The subgluteal space lies beneath the gluteus maximus muscle, containing the sciatic nerve, inferior gluteal vessels, posterior femoral cutaneous nerve, and proximal hamstring tendons. It communicates with the greater sciatic foramen and ischioanal fossa.
Deep gluteal syndrome (subgluteal space syndrome) encompasses sciatic nerve compression by piriformis, obturator internus, gemelli, or fibrovascular bands in the subgluteal space. Endoscopic subgluteal space surgery releases compressive structures. MRI of this space identifies the level and cause of sciatic nerve entrapment. It is distinct from piriformis syndrome (piriformis-specific).
Sciatic nerve compression in the subgluteal space from various non-discal causes including piriformis syndrome, ischiofemoral impingement, and fibrovascular bands, producing posterior buttock and leg pain managed by endoscopic subgluteal space decompression.
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