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Combination of Gluteal Trigger Points Dry Needling and Percutaneous Endoscopic Lumbar Discectomy for Complex Low
Shuiqing Li1, Duan Yi1, Qipeng Luo1
1Department of Pain Medicine, Peking University Third Hospital, Beijing 100191, People's Republic of China.
Purpose:
Causes of low back-related leg pain (LBLP) can be complex and diverse. A detailed medical history, physical examination, laboratory tests, and imaging are necessary to accurately distinguish the pathomechanisms of LBLP and determine the most appropriate treatment.
Case:
In this study, we report the first documented case in which the combination of dry needling (DN) and percutaneous endoscopic lumbar discectomy (PELD) was used for a patient with active myofascial trigger points (MTrPs) in the gluteus minimus muscle as well as L3-4 lumbar disc herniation (LDH). This 63-year-old woman complained of LBLP for 3 months. After careful examination and analysis, we determined this pain originated from two active MTrPs in the gluteal region and not LDH in L3-4. We first performed MTrPs DN, and the patient's LBLP was relieved completely. We then performed PELD at the L3-4 level for residual numbness on the medial and anterior aspect of the left lower limb. Finally, the patient received a satisfactory result.
Conclusion:
The gluteal MTrPs test may be used as a routine examination for patients with LBLP, especially when clinical findings are discordant with imaging results.
