The role of the greater trochanter pain syndrome in lumbar degenerative disc disease surgery

Arkadii I Kazmin; Vladimir S Pereverzev; Darya D Tesakova; Sergey V Kolesov

doi:10.1007/s00264-024-06214-4

The role of the greater trochanter pain syndrome in lumbar degenerative disc disease surgery

Int Orthop. 2024 May 14. doi: 10.1007/s00264-024-06214-4. Online ahead of print.

Authors

Arkadii I Kazmin¹, Vladimir S Pereverzev², Darya D Tesakova^{2

3}, Sergey V Kolesov²

Affiliations

¹ Department of Spine Pathology, N. N. Priorov National Medical Research Center, Priorov Str., 10, 127299, Moscow, Russia. kazmin.ark@gmail.com.
² Department of Spine Pathology, N. N. Priorov National Medical Research Center, Priorov Str., 10, 127299, Moscow, Russia.
³ Department of Traumatology and Orthopedics, Russian Medical Academy of Continuous Professional Education, Barrikadnaya Str., 2/1, B. 1, 125993, Moscow, Russia.

PMID: 38743297
DOI: 10.1007/s00264-024-06214-4

Abstract

Purpose: Greater trochanter pain syndrome (GTPS) is highly discussed during spine surgeons, accompanies lumbar pain and complicates differential diagnosis. The aim is to raise awareness among physicians and demonstrate the lumbar spine degenerative diseases (LSDD) association with GTPS.

Methods: A retro-prospective analysis enrolled 172 patients with LSDD with GTPS signs. Group I - retrospective (n = 112), group II - prospective (n = 60). Patients of group II with the confirmed diagnosis clinically and by the ultrasound recieved a GCS injection (Betamethasone 2 mg\ml + 5 mg\ml - 1.0). Also the VAS, X-ray and SPSS Statistics package were used.

Results: 112 patients in group I, 89 (79.5%) had increased pain in the hip early postOp to 7.8 points by VAS. All patients required trigger point injections of GCS and 68 (77%) received a repeat injection. 76 from 112 patients were tracked for long-term results, and recurrence of GTPS was detected in five people who treated conservatively for three months without dynamics. They were identified GTPS by ultrasound. During the injection, 39 from 43 (90%) patients noted pain reduction to 2.1 by VAS, but symptoms of radiculopathy or spinal stenosis persisted. Two patients (5%) did not note any changes. Two patients (5%) noted complete pain regression and refused the surgery.

Conclusion: Timely detection of GTPS among spinal surgeons influences tactics and, in some cases, allows one to avoid unnecessary surgical interventions. In turn, ignoring the symptoms of GTPS in the preoperative period can lead to pain intensification in the greater trochanter after surgery for degenerative diseases of the spine.

Keywords: Greater trochanter pain syndrome; Lumbar spine degenerative diseases; Radicular pain; Spine surgery.