How is electromyography-guided piriformis injection administered?

Updated: Nov 03, 2020
  • Author: Mary Louise Caire, MD; Chief Editor: Erik D Schraga, MD  more...
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For piriformis injection under EMG guidance, insert a disposable injectable monopolar needle electrode (23-25 gauge; 2-5 in.) is inserted at the midpoint of a line drawn from the posterior superior iliac spine to the greater trochanter. The needle should touch bone and then be withdrawn slightly.

Piriformis recruitment is tested by means of external rotation of the thigh. Once needle placement is confirmed, 40 mg of triamcinolone, together with 2-3 mL of 0.5% ropivacaine or bupivacaine, is infiltrated into the muscle.

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