Greater Trochanteric Pain Syndrome in Patients with Degenerative Lumbar Spine Disease: Clinical Findings and Short-Term Outcomes in a Retrospective Cohort Study.

Background

Greater trochanteric pain syndrome (GTPS) may coexist with lumbar degenerative spine disease (LDSD) and complicate pain attribution.

Methods

This retrospective cohort study evaluated the observed frequency and short-term clinical course of GTPS in a selected tertiary-care LDSD population and explored factors associated with a previous surgical recommendation. Among 153 consecutive eligible patients with clinically compatible and MRI-documented LDSD, 63 had clinical suspicion of GTPS; all 63 underwent hip MRI, demonstrated findings consistent with trochanteric bursitis, received ultrasound-guided trochanteric bursa injection plus a two-week non-steroidal anti-inflammatory drug course, and completed one- and three-month follow-up.

Results

GTPS-related lateral hip pain decreased from 7.65 ± 0.86 at baseline to 2.62 ± 0.68 at one month and 1.97 ± 1.43 at three months (Friedman p < 0.001; Kendall's W = 0.896). Twenty-five patients (39.7%) had received an outside-center lumbar surgical recommendation before GTPS recognition. In exploratory multivariable analysis, each additional pre-diagnosis outpatient visit (OR 5.82; 95% CI 2.41-14.07) and prior lumbar surgery (OR 8.75; 95% CI 1.23-62.15) were associated with previous surgical recommendation.

Conclusions

These findings support careful assessment of extra-spinal pain generators in LDSD, while the retrospective uncontrolled design precludes causal inference.