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The clinical outcomes after surgical treatment of mass lesions causing sciatica - a single-center retrospective study

Introduction/Objective Sciatica is a disabling pathology with variable
 etiologies. The most common pathologies arise from discogenic or
 non-discogenic causes. Mass lesions are a rare cause of extraspinal
 sciatica, which have been commonly overlooked, leading to unnecessary spinal
 surgeries, delay in diagnosis or inadequate treatment. There is no standard
 surgical approach and functional outcomes after surgical treatment of these
 lesions are not well-known. The aim of this study is to evaluate clinical
 outcomes after surgical treatment of mass lesions causing sciatica in
 different locations. Methods Data were obtained by a retrospective review
 from 2015-2020. The mean duration of symptoms at the time of surgery was
 10.3 months (3-48 months). The mean age of patients at the time of surgery
 was 43.8 years (14-73 years). The mean follow-up was 19.5 months (4-50
 months). In total, 14 cases had an extrapelvic localization distal to
 sciatic notch. The other three cases had lesions in the intrapelvic area,
 including left sciatic notch (1), right acetabulum (1), sacroiliac and
 lumbosacral region (1). None of the patients had palpable masses.
 Transgluteal, infragluteal, lateral, and posteromedial approach were used
 depending on location and size of the lesion. Results At the final
 follow-up, all patients recovered pain relief. The median musculoskeletal
 tumor society score was 90% (70-100). There was no recurrence at the latest
 follow-up. Conclusion Our study demonstrated that early detection by
 neurological examination and radiological work-up can avoid unnecessary
 surgeries, enable early surgical treatment of tumoral mass with satisfactory
 clinical outcomes. The surgical approach should be individualized according
 to location and size of the lesion.