Deep Gluteal Space, Peripheral Compartment, and Peritrochanteric Disorders

Abstract

Deep gluteal syndrome is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip, or posterior thigh and/or radicular pain due to a nondiscogenic sciatic nerve entrapment in the subgluteal space. The whole sciatic nerve trajectory in the deep gluteal space can be addressed by an endoscopic surgical technique, allowing treatment of diverse causes of sciatic nerve entrapment. Endoscopic decompression of the sciatic nerve appears useful in improving function and diminishing hip pain in sciatic nerve entrapments within the subgluteal space. Greater trochanteric pain syndrome has expanded to include a number of disorders, including trochanteric bursitis, tears of the gluteus medius and minimus, and external coxa saltans. This article reviews known and new etiologies of deep gluteal syndrome, assesses the role of orthopedic surgeons in the diagnosis and treatment of sciatic nerve entrapments in the subgluteal, and reviews the present understanding of the lesions that comprise greater trochanteric pain syndrome.