title: Decompression of the gluteus medius muscle as a new treatment for buttock pain: technical note.
abstract: OBJECTIVE
  The clinical features and etiology of low back pain and buttock pain remain poorly understood. We report ten patients with buttock pain who underwent gluteus medius muscle (GMeM) decompression under local anesthesia.
  
  
  METHODS
  Between December 2012 and November 2013 we surgically treated ten patients (four men, six women; mean age 65.1 years) for buttock pain. The affected side was unilateral in seven and bilateral in three patients (total sites, n = 13). The interval from symptom onset to treatment averaged 174 months; the mean postoperative follow-up period was 24 months. Decompression of the tight gluteal aponeurosis over the GMeM was performed under local anesthesia. Assessment of the clinical outcomes was on the numeric rating scale (NRS) for low back pain (LBP), the Japanese Orthopedic Association (JOA) score, and the Roland-Morris Disability Questionnaire (RDQ) score before and at the latest follow-up after treatment.
  
  
  RESULTS
  There were no intraoperative surgery-related complications. The buttock pain of all patients was improved after surgery; their NRS decreased from 7.0 to 0.8 and JOA and RMDQ scores indicated significant improvement (p < 0.05).
  
  
  CONCLUSIONS
  In patients with buttock pain, pain around the GMeM should be considered as a causative factor. Less invasive surgery with cutting and opening of the tight gluteal aponeurosis over the GMeM under local anesthesia yielded excellent clinical outcomes.
authors.affiliation: Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, 1715, Kamagari, Inzai, Chiba, Japan. kyongson@nms.ac.jp.
authors.forename: Kyongsong
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
authors.forename: Toyohiko
authors.initials: T
authors.lastname: Isu
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Chiba
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
authors.forename: Naotaka
authors.initials: N
authors.lastname: Iwamoto
authors.affiliation: Department of Neurosurgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Daijiro
authors.initials: D
authors.lastname: Morimoto
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Isobe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002081:Buttocks / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000150:complications*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D059352:Musculoskeletal Pain / Q000150:complications / Q000601:surgery*; D010147:Pain Measurement; D016896:Treatment Outcome
keywords: Buttock pain; Decompression; Gluteal aponeurosis; Gluteus medius muscle; Less invasive surgery; Low back pain