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

Abstract

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.