The frequency of superior cluneal nerve entrapment diagnosed with ultrasound-guided nerve block in patients with low back pain: A prospective, cross-sectional study.

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  • Additional Information
    • Source:
      Publisher: Blackwell Science, Inc Country of Publication: United States NLM ID: 101130835 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1533-2500 (Electronic) Linking ISSN: 15307085 NLM ISO Abbreviation: Pain Pract Subsets: MEDLINE
    • Publication Information:
      Original Publication: Malden, Mass. : Blackwell Science, Inc., c2001-
    • Subject Terms:
      Low Back Pain*/diagnostic imaging ; Low Back Pain*/etiology ; Nerve Block*/methods ; Nerve Compression Syndromes*/diagnostic imaging; Humans ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Adult ; Prospective Studies ; Aged ; Ultrasonography, Interventional/methods ; Ultrasonography/methods
    • Abstract:
      Introduction: To determine the frequency of superior cluneal nerve entrapment (SCN-E) in patients who applied to our outpatient clinic with low back pain.
      Methods: Two hundred patients with mechanical low back pain persisting more than 3 months were included in our study. All patients were evaluated with detailed clinical history and physical examination. Ultrasound-guided diagnostic injection was performed in patients who had tenderness on the posterior iliac crest and whose main complaint emerged by pressing on this point. Patients with 70% or greater pain relief 1 h after the injection were considered as SCN-E. The frequency and clinical features of SCN-E were determined and compared with other mechanical low back pain.
      Results: The mean age of the patients included in our study was 48.56 ± 14.11 years, with 138 female and 62 male patients. The diagnostic injection was performed on 31 patients and considered positive in 24 of them. The frequency of SCN-E was determined as 12%. The Hip-Knee Flexion Test was determined to be more specific for SCN-E than other causes of low back pain, the sensitivity and specificity of the test were 41.67% and 88.64% (p = 0.001; p < 0.01). In addition, all demographic and clinical features in patients diagnosed with SCN-E were found to be similar to other mechanical low back pain cases.
      Conclusions: In patients with chronic low back pain, SCN-E is not a rare cause and is often overlooked. Increasing the awareness and experience of physicians on SCN-E will prevent patients from being exposed to unnecessary surgical or non-surgical treatments.
      (© 2024 World Institute of Pain.)
    • References:
      Konno T, Aota Y, Kuniya H, Saito T, Qu N, Hayashi S, et al. Anatomical etiology of “pseudo‐sciatica” from superior cluneal nerve entrapment: a laboratory investigation. J Neurosurg Spine. 2013;19(1):76–80.
      Maigne J, Lazareth J, Surville HG, Maigne R. The lateral cutaneous branches of the dorsal rami of the thoraco‐lumbar junction. Surg Radiol Anat. 1989;11(4):289–293.
      Kuniya H, Aota Y, Saito T, Kamiya Y, Funakoshi K, Terayama H, et al. Anatomical study of superior cluneal nerve entrapment. J Neurosurg Spine. 2013;19(1):76–80.
      Iwanaga J, Simonds E, Schumacher M, Oskouian RJ, Tubbs RS. Anatomic study of superior cluneal nerves: revisiting the contribution of lumbar spinal nerves. World Neurosurg. 2019;128:e12–e15.
      Maigne J‐Y, Doursounian L. Entrapment neuropathy of the medial superior cluneal nerve: nineteen cases surgically treated, with a minimum of 2 years' follow‐up. Spine. 1997;22(10):1156–1159.
      Tubbs RS, Levin MR, Loukas M, Potts EA, Cohen‐Gadol AA. Anatomy and landmarks for the superior and middle cluneal nerves: application to posterior iliac crest harvest and entrapment syndromes. J Neurosurg Spine. 2010;13(3):356–359.
      Helm S, Irvine U. Superior and middle Cluneal nerve entrapment: a cause of low Back and radicular pain. Pain Physician. 2022;25:E503–E521.
      Isu T, Kim K, Morimoto D, Iwamoto N. Superior and middle cluneal nerve entrapment as a cause of low back pain. Neurospine. 2018;15(1):25–32.
      Erdem HR, Koçak FA, Şaş S. One of the overlooked causes of low Back pain: superior Cluneal nerve entrapment neuropathy. J PMR Sci. 2020;23(1):41–47.
      Strong EK, Davilla JC. The cluneal nerve syndrome; a distinct type of low back pain. Ind Med Surg. 1957;26(9):417–429.
      Kuniya H, Aota Y, Kawai T, Kaneko KI, Konno T, Saito T. Prospective study of superior cluneal nerve disorder as a potential cause of low back pain and leg symptoms. J Orthop Surg Res. 2014;9(1):1–12.
      Desai MJ, Nepaul S. Cluneal neuropathy: background, diagnosis, and treatment. Pain Pract. 2023;23(4):437–446.
      Aly TA, Tanaka Y, Aizawa T, Ozawa H, Kokubun S. Medial superior cluneal nerve entrapment neuropathy in teenagers: a report of two cases. Tohoku J Exp Med. 2002;197(4):229–231.
      Karri J, Singh M, Orhurhu V, Joshi M, Abd‐Elsayed A. Pain syndromes secondary to Cluneal nerve entrapment. Curr Pain Headache Rep. 2020;24(10):1–6.
      Gautam S, Gupta N, Khuba S, Agarwal A, Kumar S, das PK. Evaluation of the efficacy of superior Cluneal nerve block in low back pain: a prospective observational study. J Bodyw Mov Ther. 2022;30:221–225.
    • Contributed Indexing:
      Keywords: cluneal nerve; low back pain; peripheral nerve block; superior cluneal nerve entrapment; ultrasonography
    • Publication Date:
      Date Created: 20240607 Date Completed: 20241111 Latest Revision: 20241111
    • Publication Date:
      20241114
    • Accession Number:
      10.1111/papr.13391
    • Accession Number:
      38849322