Endoscopic Management for Posterior Hip Pain as Deep Gluteal Syndrome (DGS)

Myung-sik Park, Hong-man Cho, Joon-Soo Ha and Hyung-bae Park

Department of Orthopaedic Surgery, Chonbuk University Hospital, Republic of Korea
Department of Orthopaedic Surgery, Gwangju Veterans Hospital, Republic of Korea
Department of Orthopaedics, King’s College Hospital, UK
Department of Biology, Chonbuk University, Republic of Korea

^*Correspondance to: Myung-sik Park 

 PDF  Full Text DOI: 10.25107/2474-1647.2460

Abstract

Purpose: The purpose of this study is to assess the effectiveness of endoscopic sciatic neurolysis of deep gluteal syndrome and evaluated the differences of clinical results according to pathology.
Methods: Retrospective study of 85 hips (85 patients, 45 males and 40 female) with mean age of 50.5 year old (range, 19 to 77 years old) with DGS treated with an endoscopic technique between 2009 and 2018 with a minimum follow-up of 12 months. Compromising structures were divided five groups: hypertrophied vascular nest in 46 hips, piriformis in 16 hips, other short external rotator in 10 hips, soft tissue mass in 3 hips and pelvic trauma in 10 hips. The patients were evaluated pain score using VAS and function by modified HHS and postoperative satisfaction graded by Benson score. Statistical significance was evaluated (p>0.05).
Results: We identified all scores improved. The Benson score was 2.82 ± 0.85 (p=0.56), mean VAS 5.69 ± 0.89 to 2.30 ± 1.72 (P=0.32), and the mean mHHS increased from 65.85 ± 5.50 to 91.40 ± 5.80 (P=0.002). Usually pain and function improve in all groups except trauma group. Trauma group was significantly lower scores versus non trauma group (p=0.04). Five patient complaint persistent pains, which were managed with second look in one patient and others, were managed with NSAIDs and sono-guided steroid injection. There were no complications related with endoscopic procedure.
Conclusion: Endoscopic sciatic neurolysis offers an alternative management of DGS by improving functionality and reducing pain levels in selected patients. Recurred pain should be evaluated sacroiliac joint pathology, spine disorder, and depression.

Keywords

Hip; Endoscopy; Sciatic nerve; Deep Gluteal Syndrome (DGS)

Cite the article

Myung-sik Park, Hong-man Cho, Joon- Soo Ha, Hyung-bae Park. Endoscopic Management for Posterior Hip Pain as Deep Gluteal Syndrome (DGS). Clin Surg. 2019; 4: 2460.