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Deep Gluteal Space with Surgical Technique

Hip Arthroscopy and Hip Joint Preservation Surgery

Abstract

A detailed understanding of the deep gluteal space is essential to overcoming the diagnostic challenge of posterior hip pain. Multiple anatomical structures course between the pelvis and lower limbs, and the source of posterior hip pain can be located in one or more of the following layers: osseous, capsulolabral, musculotendinous, neurovascular, and kinematic chain. The kinematic chain represents the biomechanical effects that abnormalities in the hip or lumbar spine have over the deep gluteal space.

This chapter presents a detailed description of the deep gluteal space anatomy and biomechanics, including the interaction with the hip and lumbar spine. The causes of posterior hip pain located in the deep gluteal space are discussed in detail, as well as a ten-step technique for sciatic nerve decompression in the deep gluteal space. This chapter will cover the following subjects: deep gluteal space anatomy and biomechanics (i.e., piriformis muscle and related structures, obturator internus muscle, pudendal nerve, hamstring origin, ischiofemoral space, superficial sensory innervation – cluneal nerves, sciatic nerve anatomy and biomechanics, hip-spine-pelvis-core biomechanics); deep gluteal space pathologies (i.e., primary deep gluteal syndrome: extra-pelvic and intrapelvic entrapments, ischiofemoral impingement, hamstring avulsion and syndrome, pudendal nerve entrapment); and deep gluteal space – surgical treatment (i.e., endoscopic sciatic nerve decompression, rehabilitation, and results).

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  1. Hip Preservation Center, Baylor University Medical Center at Dallas, Dallas, TX, USA

    Munif Hatem & Hal David Martin

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Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Bedi Asheesh

  3. Department of Orthopedic Surgery, Case Western Reserve University, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopedic Surgery, Duke Medical Center, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopedic Surgery, Weill Medical College of Cornell Univers, New York, NY, USA

    Bryan T. Kelly

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  1. Houston Methodist Center for Orthopaedics & Sports Medicine, Houston, TX, USA

    Joshua D. Harris

  2. Rush University Medical Center, Chicago, IL, USA

    Joshua D. Harris

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Hatem, M., Martin, H.D. (2021). Deep Gluteal Space with Surgical Technique. In: Nho, S.J., Asheesh, B., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7321-3_75-2

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    Deep Gluteal Space with Surgical Technique
    Published:
    22 May 2021

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_75-2

  2. Original

    Deep Gluteal Syndrome
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    21 June 2014

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_75-1

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