Superior Cluneal Nerve Entrapment Eight Years after Decubitus Surgery

Akbaş, Mert; Yeğin, Arif; Karslı, Bilge

doi:10.1111/j.1533-2500.2005.00040.x

Cited by 29 publications

(16 citation statements)

References 7 publications

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“…Branches of SCN extend from a site of discontinuity of the fascia and innervates the buttocks cutaneously. [11][12][13] The SCN entrapment at the osteofibrous orifice, where it penetrates the thoracolumbar fascia, produces LBP. 8,12,13 Low back pain because of SCN entrapment is induced and exacerbated by movements such as rising, sitting, rolling over, crouching, lateral bending, and rotating, and by prolonged sitting, standing, or walking.…”

Section: Discussionmentioning

confidence: 99%

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Superior Cluneal Nerve Entrapment—Possible Pain Generator in Low Back Pain

Sidhaye¹,

Keniya²,

Kulkarni³

2019

Journal on Recent Advances in Pain

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High number of patients coming to pain clinic complain of low back pain (LBP) and this puts the pain physician in lot of diagnostic predicament. Consideration of common reasons from myofascial pain generator to rarer like cluneal nerve entrapment requires updating of knowledge regarding various rare pain generators in the back region. The cutaneous branches of cluneal nerve, namely, superior and middle are purely sensory. They provide sensation in the lumbar region and the buttocks, and their impingement around the iliac crest can cause LBP radiating to lower limb. Diagnosing uncommon cause for LBP owing to superior cluneal nerve impingement becomes a challenging task due to the absence of any diagnostic criteria apart from the high-index suspicion based on clinical findings and ruling out other common causes of LBP. It is usually misdiagnosed as a lumbar spine disorder. Here we present a case of chronic low backache with vague symptoms, which was successfully treated with the cluneal nerve block and the diagnosis of cluneal nerve entrapment was confirmed.

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Section: Discussionmentioning

confidence: 99%

“…However, its etiology remains poorly understood. 10,11,14,15 Ermis et al 4 stated that the SCNs supply the skin of the upper part of the buttocks. The tunnel where entrapment of the medial branch of the SCN usually occurs is found on the iliac crest approximately 7-7.5 cm away from the midline.…”

Section: Discussionmentioning

confidence: 99%

Superior Cluneal Nerve Entrapment—Possible Pain Generator in Low Back Pain

Sidhaye¹,

Keniya²,

Kulkarni³

2019

Journal on Recent Advances in Pain

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“…SCN originates at the rami laterales of the posterior branch of the spinal nerve and pierces the thoracolumbar fascia to occupy the cranial buttocks over the iliac crest 5,[23][24][25] . The SCN branches extend from the site of perforation on the fascia to innervate the buttocks cutaneously 5,[23][24][25][26][27][28] . Entrapment of SCN at the osteofibrous orifice where it penetrates the thoracolumbar fascia induces LBP 26,27,29) .…”

Section: Discussionmentioning

confidence: 99%

Treatment of low back pain elicited by superior cluneal nerve entrapment neuropathy after lumbar fusion surgery

Iwamoto

Isu

Kim

et al. 2017

Spine Surg Relat Res

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Object: Low back pain (LBP) attributable to fusion failure, implant failure, infection, malalignment, or adjacent segment disease may persist after lumbar fusion surgery (LFS). Superior cluneal nerve (SCN) entrapment neuropathy (SCNEN) is a clinical entity that can produce LBP. We report that SCNEN treatment improved LBP in patients who had undergone LFS.Methods: Between April 2012 and August 2015, we treated 8 patients (4 men and 4 women ranging in age from 38 to 88 years; mean age, 69 years) with SCNEN for their LBP after LFS. Our criteria for the diagnosis of SCNEN included a trigger point over the posterior iliac crest 7 cm from the midline and numbness and radiating pain in the SCN area upon compression of the trigger point. Symptom relief was obtained in more than 75% of patients within 2 h of inducing a local nerve block at the trigger point in the buttocks. The mean postoperative follow-up period was 28 months (range, 9-54 months).Results: LBP was unilateral in 3 and bilateral in 5 patients. The senior author (T.I.) operated all patients for SCNEN under local anesthesia because they reported recurrence of pain after the analgesic effect of repeat injections wore off. This led to a significant improvement of their LBP.Conclusions: SCNEN should be considered in patients reporting LBP after LFS. Treatment of SCNEN may be a useful option in patients with failed back surgery syndrome after LFS.

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“…After the first report of a series of patients whose LBP was ameliorated by SCN decompression at the orifice of the thoracolumbar fascia, 14 others [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] documented LBP due to SCN-E. However, the pathologic background of this type of LBP has not been extensively studied.…”

Section: Discussionmentioning

confidence: 99%

“…The etiology of low back pain (LBP) is heterogeneous and unknown in some patients with chronic pain. 1 Superior cluneal nerve entrapment (SCN-E) has been proposed as a causative factor [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] ; its reported incidence ranges from 1.6%-14%. 10,11 The SCN derives from the cutaneous branches of the dorsal rami at T11-L4 and innervates the skin of the upper part of the buttocks.…”

mentioning

confidence: 99%