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Acta Neurochir (Wien). 2019 May 3. doi: 10.1007/s00701-019-03923-3. [Epub ahead of print]

Gluteus medius muscle decompression for buttock pain: a case-series analysis.

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Department of Neurosurgery, Kushiro Rosai Hospital, Kushiro City, Hokkaido, Japan.
Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, 1715, Kamagari, Inzai City, Chiba, Japan.
Department of Neurosurgery, Kushiro Rosai Hospital, Kushiro City, Hokkaido, Japan.
Department of Neurosurgery, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.



The causes of low back and buttock pain are variable. Elsewhere, we presented a surgical technical note addressing the gluteus medius muscle (GMeM) pain that elicited buttock pain treatable by surgical decompression. Here, we report minimum 2-year surgical outcomes of GMeM decompression for intractable buttock pain.


Between January 2014 and December 2015, we surgically treated 55 consecutive patients with a GMeM pain. Of these, 39 were followed for at least 2 years; they were included in this study. Their average age was 69.2 years; 17 were men and 22 were women. The affected side was unilateral in 24 patients and bilateral in the other 15 (total 54 sites). The mean follow-up period was 40.0 months (range 25-50 months). The severity of pre- and post-treatment pain was recorded on the numerical rating scale (NRS) and the Roland-Morris Disability Questionnaire (RDQ).


Of the 39 patients, 35 also presented with leg symptoms. They were exacerbated by walking in all 39 patients and by prolonged sitting in 33 patients; 19 had a past history of lumbar surgery and 4 manifested failed back surgery syndrome. Repeat surgery for wider decompression was performed in 5 patients due to pain recurrence 15.8 months after the first operation. At the last follow-up, the symptoms were significantly improved; the average NRS fell from 7.4 to 2.1 and the RDQ score from 10.5 to 3.3 (p < 0.05).


When diagnostic criteria are met, GMeM decompression under local anesthesia is a useful treatment for intractable buttock pain.


Buttock pain; Case series; Decompression surgery; Gluteus medius muscle; Surgical results


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