Ultrasound-guided Transgluteal Sciatic Nerve Hydrodissection for the Treatment of Sciatica in the Emergency Department

Ultrasound Guided Transgluteal Sciatic Nerve Hydrodissection for the Treatment of Sciatica in the Emergency Department

The goal of this observational study is to see whether it would be feasible to treat patients who come to the emergency department with pain related to sciatica using an ultrasound guided injection of dextrose in water solution ("sugar water") into the tissue that surrounds the sciatic nerve in the gluteal region. THe study will looks at a few things:

• Is the treatment feasible within the setting of the emergency department
• Is the treatment safe in the short term (up to 72 hours after the injection)
• Is the treatment good for lowering patients' pain from sciatica in the short term (immediate and up to 72 hours' follow up)
• How does the treatment compare to current standard medicines given to patients for sciatica in the emergency department in terms of lowering pain

Patients who came to the emergency department and had the injection as part of their care for sciatica will answer some questions about their symptoms during a phone call follow up 72 hours after leaving the emergency department.

Inclusion Criteria:

• Age 18 years or older
• Clinically diagnosed acute sciatica, defined as pain and/or paresthesias in a -sciatic nerve distribution
• Willing to undergo the injection procedure
• Verbal informed consent provided prior to enrollment
• Adequate sonographic visualization of the sciatic nerve in the transgluteal window confirmed on screening ultrasound

Exclusion Criteria:

• Fever or signs of systemic infection
• Suspected spinal infection
• Suspected spinal malignancy
• Signs or symptoms of cauda equina syndrome
• Acute traumatic mechanism of pain
• Localized infection or skin breakdown at the proposed injection site
• Known allergy to study injectate (5% dextrose in water) or procedural materials
• Refusal to participate
• Inability to adequately visualize the target anatomy on ultrasound for safe injection