Watch That Sciatic Nerve!

The sciatic nerve can sustain damage via trauma, injections, or surgical intervention. The medical records of 103 dogs and cats with monoparetic peripheral nerve lesions were examined. Twenty-seven animals (18 dogs, 9 cats) were determined to have iatrogenic sciatic nerve injury. Animals were neurologically normal before treatment, and clinical signs developed immediately after treatment. Damage to the sciatic nerve occurred during surgery in 25 cases. In 18 cases, damage occurred during repair of pelvic fractures. The other cases included repair of iliosacral luxations, intramedullary pinning of femoral fractures, hip replacement, tibial plateau-leveling osteotomy, and repair of perineal hernias. Two cases were caused by intramuscular injections (1 cat, 1 dog). Injuries associated with pelvic surgery were treated conservatively with physiotherapy. Patients with implant-associated sciatic nerve damage were treated by immediate removal of the pin, extruded cement in cases of total hip repair, and removal of sutures entrapping the nerve in the case of perineal hernia. At the end of 1 year, 14 animals (8 dogs, 6 cats) were reported to have had a good outcome, 6 had fair outcomes (4 dogs, 2 cats), and 7 had poor outcomes (6 dogs, 1 cat). One cat was euthanized. Five of the 6 dogs with poor outcomes had acetabular fracture/plating or ilial fracture/plating. Iatrogenic sciatic nerve damage occurred most commonly during surgical repair of pelvic disorders. Prognosis for a full functional recovery was uncertain.