title: Which level is responsible for gluteal pain in lumbar disc hernia?
abstract: There are many different reasons why patients could be experiencing pain in the gluteal area. Previous studies have shown an association between radicular low back pain (LBP) and gluteal pain (GP). Studies locating the specific level responsible for gluteal pain in lumbar disc hernias have rarely been reported.
  
  
  
  All patients with lumbar disc herniation (LDH) in the Kanghua hospital from 2010 to 2014 were recruited. All patients underwent a lumbar spine MRI to clarify their LDH diagnosis, and patients were allocated to a GP group and a non-GP group. To determine the cause and effect relationship between LDH and GP, all of the patients were subjected to percutaneous endoscopic lumbar discectomy (PELD).
  
  
  
  A total of 286 cases were included according to the inclusive criteria, with 168 cases in the GP group and 118 cases in the non-GP group. Of these, in the GP group, 159 cases involved the L4/5 level and 9 cases involved the L5/S1 level, while in the non-GP group, 43 cases involved the L4/5 level and 48 cases involved the L5/S1 level. PELD was performed in both groups. Gluteal pain gradually disappeared after surgery in all of the patients. Gluteal pain recrudesced in a patient with recurrent disc herniation (L4/5).
  
  
  
  As a clinical finding, gluteal pain is related to low lumbar disc hernia. The L4/5 level is the main level responsible for gluteal pain in lumbar disc hernia. No patients with gluteal pain exhibited involvement at the L3/4 level.
authors.affiliation: Anatomical Institute of Minimally Invasive Surgery, Southern Medical University, Guangzhou, 510515, China.|Department of Orthopedics, Shenzhen Hospital of Southern Medical University, NO.1333, Xinhu Road, Shenzhen, 518100, China.
authors.forename: Guofang
authors.initials: G
authors.lastname: Fang
authors.affiliation: Spine Department of Kanghua Hospital, Dongguang city, Guangdong Province, China.
authors.forename: Jianhe
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Anesthesia, Shenzhen Hospital of Southern Medical University, NO.1333, Xinhu Road, Shenzhen, 518100, China.
authors.forename: Yutan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Shenzhen Hospital of Southern Medical University, NO.1333, Xinhu Road, Shenzhen, 518100, China.
authors.forename: Hongxun
authors.initials: H
authors.lastname: Sang
authors.affiliation: Spine Department of Kanghua Hospital, Dongguang city, Guangdong Province, China.
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Xu
authors.affiliation: Anatomical Institute of Minimally Invasive Surgery, Southern Medical University, Guangzhou, 510515, China. 189962700@qq.com.
authors.forename: Zihai
authors.initials: Z
authors.lastname: Ding
mesh_terms: D000328:Adult; D002081:Buttocks / Q000294:innervation*; D017587:Diskectomy, Percutaneous; D004724:Endoscopy; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology* / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Gluteal pain; LBP; LDH; Percutaneous endoscopic lumbar discectomy